Ashleigh M. Holmes

Abstract

To determine the mediating effects of the quality of family caregivers' relationships with their older adult care recipients on the association between care-giver burden and caregivers' mental health and perceived general health.

Abstract

~

Abstract

~

Abstract

~

Abstract

A comprehensive understanding of the patterns of psychosocial characteristics in older adults with pain is needed. Our objectives were to (1) identify psychosocial phenotypes (comprising depression, anxiety, affect, self-realization, resilience, and social participation) among older adults with pain and (2) compare pain characteristics, physical health, and cognition among the identified phenotypes. Using cross-sectional 2021 data from the National Health and Aging Trends Study, we performed latent class analysis to identify four psychosocial phenotypes of older adults with pain ( = 1903): Favorable (best psychosocial characteristics, 67.7%), Adverse (worst psychosocial characteristics, 4.9%), Intermediate (moderate scores on psychosocial variables, 12.6%), and Compensated (moderate scores with relatively high self-realization and resilience, 14.9%). Phenotypes with less psychosocial adversity had generally better clinical outcomes. Future research should explore precision pain management interventions in older adults based on their psychosocial phenotypes, longitudinal trajectories of phenotypes, and technology-based, point-of-care clinical insights for pain management.

Abstract

~

Abstract

Although pain is prevalent in older adults, there are gaps in the existing literature regarding multivariable psychosocial contributors to pain outcomes. Identifying psychosocial phenotypes, or patterns of psychological and social characteristics, can help predict outcomes; however, further longitudinal analysis is required. This study explores the stability of psychosocial phenotypes longitudinally in older adults with pain, along with the predictors of transitions in phenotypes over time. Using 2018-2022 annual National Health and Aging Trends Study data, 813 older adults consistently reported pain. Psychosocial variables used in the analysis included depression, anxiety, affect, self-realization, resilience, self-efficacy, and social participation. Latent transition analysis was used to identify optimal psychosocial phenotypes and proportions of participants transitioning to different phenotypes longitudinally. Baseline variables (pain characteristics, physical, cognitive) associated with longitudinal transitions in psychosocial phenotypes were determined via logistic regression. Latent transition analysis resulted in three psychosocial phenotypes (Adverse, Favorable, and Intermediate) based on scores on psychosocial variables. Longitudinally, phenotype membership remained generally stable with a trend towards increased psychosocial adversity. Baseline cognition and physical performance were predictors of transitions to less adverse phenotypes longitudinally. In contrast, baseline sleep, physical performance, pain limitations, and self-rating of general health were predictors of transitions to more adverse phenotypes. There is stability in psychosocial well-being longitudinally in older adults with pain and a remarkable ability to rebound despite major stressors. Future research should explore interventions that promote transitions to more favorable psychosocial phenotypes, develop point-of-care clinical insights, and advance precision pain medicine. PERSPECTIVE: This study analyzed psychosocial phenotypes in older adults with chronic pain using latent transition analysis. It identified stable phenotypes (Adverse, Intermediate, Favorable) and tracked changes over time. Findings highlight the impact of cognitive and physical health on psychosocial well-being, supporting personalized interventions and advancing precision pain medicine in older adults.

Abstract

Neuropathic pain encompasses multiple diagnoses with detrimental impacts on quality of life and overall health. In older adults, pharmacological management is limited by adverse effects and drug interactions, while surgical management involves perioperative risk. Prior reviews addressing non-pharmacological interventions for neuropathic pain have not focused on this demographic. Therefore, this systematic review synthesizes the evidence regarding the effectiveness of non-pharmacological interventions in reducing neuropathic pain severity in older adults.

Abstract

To compare psychosocial outcomes of older adults according to pain experience.

Abstract

Collaborative care models (CCMs) have robust research evidence in improving mental health outcomes for diverse patient populations with complex health care needs. However, the impact of CCMs on primary care provider (PCP) outcomes are not well described.