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Table 3 Demographic and clinical characteristics of older patients with chronic pain with or without ADRD residing in a nursing home stratified by cohort

From: Quality of opioid prescribing in older adults with or without Alzheimer disease and related dementia

Baseline characteristica

Patients with chronic pain, %

 

Opioid-naive patients, %

 

Patients with neuropathic pain

 

Patients with opioid prescription, %

 

Patients with moderate to severe pain, %b

 

With ADRD

Without ADRD

P-valueg

With ADRD

Without ADRD

P-valueg

With ADRD

Without ADRD

P-valueg

With ADRD

Without ADRD

P-valueg

With ADRD

Without ADRD

P-valueg

Total no.

37,117

5128

23,205

2761

2602

686

17,570

3180

10,971

2329

Age, y

 Mean (SD)

82.2 (10.5)

73.1 (12.8)

< .001

82.6 (10.4)

73.8 (13.0)

< .001

77.3 (11.4)

69.2 (10.9)

< .001

81.6 (10.5)

72.9 (12.5)

< .001

80.9 (10.6)

72.7 (12.5)

< .001

 50–64

7.1

28.2

 

6.8

26.8

 

15.2

34.5

 

7.6

27.8

 

8.5

28.7

 

 65–74

14.6

27.4

13.7

26.1

23.0

34.7

15.7

28.8

17.2

28.3

 75–84

29.8

21.0

29.4

21.3

31.0

21.0

30.5

21.0

31.2

20.8

  ≥ 85

48.4

23.4

50.0

25.8

30.8

9.8

46.1

22.3

43.2

22.1

Female

75.4

64.3

< .001

73.0

61.1

< .001

70.6

61.3

< .001

78.3

67.5

< .001

78.9

69.3

< .001

Race/ethnicity

 White

80.4

81.4

.205

78.6

80.3

.114

77.6

81.8

.082

83.1

82.7

.128

84.8

84.3

.662

 Black

14.1

13.2

15.1

13.7

15.4

12.6

12.8

12.4

11.6

11.7

 Othersc

5.5

5.4

6.3

5.9

7.0

5.6

4.1

4.9

3.7

4.0

US region

 Northeast

23.2

18.8

< .001

27.6

22.2

< .001

23.1

19.8

< .001

17.2

16.3

< .001

19.3

17.5

< .001

 Midwest

26.2

34.4

25.1

34.7

25.4

33.1

27.7

34.3

29.9

36.0

 South

40.0

33.1

37.1

30.9

38.7

33.2

44.3

35.5

40.7

32.7

 West or other regions

10.5

13.6

10.3

12.2

12.8

13.9

10.8

13.9

10.1

13.8

Low-income subsidy

82.5

79.6

< .001

81.2

76.1

< .001

85.1

81.2

.018

82.5

79.9

< .001

83.9

81.5

.006

Tobacco or alcohol use

5.3

8.9

< .001

4.6

7.8

< .001

6.8

8.1

.259

6.5

9.6

< .001

7.3

9.4

< .001

Drug use disorder

1.7

3.0

< .001

1.1

1.5

.051

2.0

2.8

.217

2.5

3.9

< .001

2.8

4.0

.002

Index pain diagnosisd

 Musculoskeletal

92.5

86.4

< .001

93.6

88.1

< .001

13.1

10.1

.044

90.8

85.1

< .001

90.6

85.1

< .001

 Neuropathic

6.0

11.8

< .001

5.6

11.3

< .001

100

100

NA

6.6

12.4

< .001

6.9

11.6

< .001

 Idiopathic

3.0

3.7

.012

1.8

1.6

.551

0.7

0.7

.956

4.7

5.1

.281

4.6

5.7

.022

Comorbidity affecting pain treatment

 Cardiovascular disease

93.2

88.1

< .001

92.0

84.5

< .001

93.0

88.3

< .001

94.4

90.1

< .001

94.6

90.1

.025

 Pulmonary condition

57.6

58.0

.565

54.1

51.5

.009

59.0

55.5

.130

62.1

61.3

.391

64.3

61.8

< .001

 Diabetes

42.5

50.7

< .001

40.5

45.9

< .001

69.2

66.3

.169

44.8

53.2

< .001

46.0

53.6

< .001

 Mental disorder

60.1

46.3

< .001

56.3

40.1

< .001

62.9

45.8

< .001

63.9

48.1

< .001

67.0

49.5

< .001

 Gastrointestinal tract disorder

43.9

36.5

< .001

41.1

32.3

< .001

45.6

38.8

.003

46.3

38.3

< .001

47.0

38.9

< .001

 Urinary tract infection

41.3

27.9

< .001

37.9

22.6

< .001

41.5

31.9

< .001

45.2

30.8

< .001

46.0

31.3

< .001

 Kidney disease

26.7

28.6

.006

24.2

23.9

.732

32.9

33.4

.809

30.2

30.8

< .001

30.8

30.7

.943

 Fall or fracture

24.0

16.7

< .001

19.8

12.3

< .001

18.9

10.6

< .001

28.5

19.4

< .001

28.5

18.7

< .001

 Neurodegenerative disease

16.4

10.6

< .001

15.5

8.7

< .001

20.6

12.1

< .001

17.2

11.5

< .001

18.5

11.8

< .001

 Liver disease

5.5

6.7

< .001

4.9

5.2

.548

6.8

7.3

.666

6.3

7.4

< .001

6.8

7.3

.423

Health care utilization

 Any hospitalization stay

31.7

29.9

.009

29.1

25.7

< .001

33.9

27.4

.003

35.9

32.5

< .001

37.7

32.4

< .001

 Any ED visit

26.5

24.8

.009

22.3

19.2

< .001

26.6

25.5

.559

30.9

28.2

.003

31.5

27.9

< .001

 Any hospital surgical procedure

7.6

9.7

< .001

6.2

7.2

.053

8.2

8.8

.642

10.0

11.4

.017

10.1

11.1

.174

ADL dependencee

 None

22.7

29.7

< .001

22.2

31.2

< .001

24.0

24.3

.207

23.3

26.8

< .001

26.5

28.5

.006

 Mild

31.6

27.8

31.8

28.1

27.7

26.1

31.7

28.1

32.0

29.2

 Moderate

29.2

29.5

28.9

27.2

30.5

34.4

29.5

32.5

28.0

30.0

 Severe

16.5

13.0

17.0

13.5

17.8

15.2

15.5

12.7

13.5

12.3

PHQ-9 depression symptomse

 None

78.7

79.8

.247

80.2

81.3

.292

78.8

83.8

.027

76.4

77.7

.233

74.0

76.6

.017

 Mild

14.7

14.2

13.8

13.5

15.1

11.4

16.3

15.6

17.7

16.4

 Moderate

4.9

4.6

4.6

4.1

4.2

4.0

5.2

5.1

5.8

5.5

 Severe

1.7

1.4

1.4

1.1

1.9

0.8

2.1

1.6

2.4

1.5

BMIe

 Underweight

7.9

7.5

< .001

7.9

7.2

< .001

5.2

6.4

< .001

8.2

7.9

< .001

7.4

7.3

< .001

 Normal weight

36.5

23.4

37.9

26.6

28.1

19.0

34.7

21.0

32.2

18.9

 Overweight

29.6

24.1

30.5

25.9

31.1

21.7

28.1

22.9

27.9

22.1

 Obese

25.9

45.0

23.6

40.2

35.6

52.9

28.9

48.1

32.4

51.7

Nursing home stay duration, mean (SD), df

326.3 (65.6)

263.8 (100.5)

< .001

325.0 (66.4)

261.7 (101.0)

< .001

316.0 (77.5)

254.9 (102.9)

< .001

323.3 (69.7)

256.3 (102.5)

< .001

331.6 (59.5)

268.0 (98.2)

< .001

  1. Abbreviations: ADRD Alzheimer disease and related dementias, ADL activities of daily living, BMI body mass index (calculated as weight in kilograms divided by height in meters squared), ED emergency department, MDS 3.0 Minimum Data Set, version 3.0, PHQ-9 Patient Health Questionnaire-9
  2. aDefined as the 6 months prior to the date of a randomly selected chronic pain diagnosis for each patient
  3. bDefined as having ≥ 1 quarterly MDS 3.0 pain assessment with a numeric rating scale score of ≥ 4 or moderate or severe pain based on the verbal descriptor scale
  4. cIncluded Hispanic, Asian, Pacific Islander, and Native American individuals
  5. dMeasured as primary or secondary diagnosis as the index diagnosis
  6. eMeasured based on the first observe quarterly MDS 3.0 assessment during 12 months after diagnosis of chronic pain, which was randomly selected per patient
  7. fMeasured during the entire 12 months after diagnosis of chronic pain, which was randomly selected per patient
  8. gStatistical comparisons and P-values were calculated using t-tests for continuous variables and chi-square tests for categorical variables
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Alzheimer's Research & Therapy

ISSN: 1758-9193