Beyond the sum of their parts: The combined association of dementia and chronic pain with self-care limitations in older Australians

Rezwanul Haque; Khorshed Alam; Jeff Gow; Christine Neville; Syed Afroz Keramat

doi:10.1016/j.jad.2024.10.046

Beyond the sum of their parts: The combined association of dementia and chronic pain with self-care limitations in older Australians

J Affect Disord. 2024 Oct 13:S0165-0327(24)01707-5. doi: 10.1016/j.jad.2024.10.046. Online ahead of print.

Authors

Rezwanul Haque¹, Khorshed Alam², Jeff Gow³, Christine Neville⁴, Syed Afroz Keramat⁵

Affiliations

¹ School of Business, University of Southern Queensland, Queensland, Toowoomba, Australia. Electronic address: rezwanul.haque@usq.edu.au.
² School of Business, University of Southern Queensland, Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Toowoomba, Australia.
³ School of Business, University of Southern Queensland, Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Toowoomba, Australia; School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa.
⁴ School of Nursing and Midwifery, University of Southern Queensland, Queensland, Toowoomba, Australia.
⁵ Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.

PMID: 39406296
DOI: 10.1016/j.jad.2024.10.046

Abstract

Background: The purpose of this study was to investigate the association between dementia, chronic pain and self-care limitations. Additionally, the study sought to explore the relationship of co-occurring dementia and chronic pain with self-care limitations.

Methods: Cross-sectional data derived from the Survey of Disability, Ageing and Carers (SDAC) was used to conduct this study. The pooled association between dementia, and chronic pain, with self-care limitations was assessed using ordered logistic regression model. Furthermore, the study also examined the group comparison of interaction effects between co-occurring dementia and chronic pain with self-care limitations.

Results: The ordered logistic regression analysis indicated that people with dementia had significantly higher odds of experiencing greater self-care limitations (adjusted odds ratio [aOR]: 15.12, 95 % confidence interval [CI]: 12.50-18.29) compared to people without dementia. Similarly, chronic pain was independently associated with increased self-care limitations (aOR: 5.98, 95 % CI: 5.49-6.52) compared to people without chronic pain. Additionally, interaction effect analysis revealed that the co-occurrence of dementia and chronic pain substantially heightened the likelihood of self-care limitations (aOR: 66.54, 95 % CI: 52.27-84.69) relative to people without either condition.

Conclusions: Disability was higher among older Australians with dementia and chronic pain, and this risk can be increased if the two conditions co-exist. A continuous, aligned, and personalised healthcare approach is needed to establish self-care priorities, especially in groups of people with the greatest need.