TY - JOUR
T1 - Factors Associated with Family Reports of Pain, Dyspnea, and Depression in the Last Year of Life
AU - Singer, Adam E.
AU - Meeker, Daniella
AU - Teno, Joan M.
AU - Lynn, Joanne
AU - Lunney, June R.
AU - Lorenz, Karl A.
N1 - Publisher Copyright:
Copyright © 2016, Mary Ann Liebert, Inc.
PY - 2016/10
Y1 - 2016/10
N2 - Background: Pain, dyspnea, and depression are highly troubling near the end of life. Objective: To characterize factors associated with clinically significant pain and the presence of dyspnea and depression during the last year of life in a nationally representative sample. Design: Retrospective cohort study. Setting: Health and Retirement Study, a national sample of community-dwelling US residents aged 51 and older. Participants: Family respondents of 8254 decedents who died between 1998 and 2012. Measurements: Clinically significant pain often during the last year of life; dyspnea and depression for at least one month during the last year of life. Results: Life support was associated with dyspnea (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.42-2.06) and depression (OR 1.20, CI 1.04-1.39), treatment for cancer with pain (OR 1.65, CI 1.41-1.92), and oxygen for a lung condition with dyspnea (OR 14.78, CI 11.28-19.38). More diagnoses were associated with dyspnea (OR 1.24, CI 1.17-1.30) and depression (OR 1.14, CI 1.08-1.21). More activities of daily living (ADL) dependencies were associated with clinically significant pain (OR 1.06, CI 1.03-1.09), dyspnea (OR 1.06, CI 1.02-1.10), and depression (OR 1.10, CI 1.07-1.12), and more instrumental activities of daily living (IADL) dependencies with depression (OR 1.12, CI 1.08-1.18). Worse self-rated health was associated with pain (OR 0.83, CI 0.77-0.88), dyspnea (OR 0.89, CI 0.84-0.95), and depression (OR 0.83, CI 0.78-0.89). Arthritis was associated with clinically significant pain (OR 2.24, CI 1.91-2.63). Conclusions: Factors associated with common, burdensome symptoms in a national sample suggest clinical and population strategies for targeting symptom assessment and management.
AB - Background: Pain, dyspnea, and depression are highly troubling near the end of life. Objective: To characterize factors associated with clinically significant pain and the presence of dyspnea and depression during the last year of life in a nationally representative sample. Design: Retrospective cohort study. Setting: Health and Retirement Study, a national sample of community-dwelling US residents aged 51 and older. Participants: Family respondents of 8254 decedents who died between 1998 and 2012. Measurements: Clinically significant pain often during the last year of life; dyspnea and depression for at least one month during the last year of life. Results: Life support was associated with dyspnea (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.42-2.06) and depression (OR 1.20, CI 1.04-1.39), treatment for cancer with pain (OR 1.65, CI 1.41-1.92), and oxygen for a lung condition with dyspnea (OR 14.78, CI 11.28-19.38). More diagnoses were associated with dyspnea (OR 1.24, CI 1.17-1.30) and depression (OR 1.14, CI 1.08-1.21). More activities of daily living (ADL) dependencies were associated with clinically significant pain (OR 1.06, CI 1.03-1.09), dyspnea (OR 1.06, CI 1.02-1.10), and depression (OR 1.10, CI 1.07-1.12), and more instrumental activities of daily living (IADL) dependencies with depression (OR 1.12, CI 1.08-1.18). Worse self-rated health was associated with pain (OR 0.83, CI 0.77-0.88), dyspnea (OR 0.89, CI 0.84-0.95), and depression (OR 0.83, CI 0.78-0.89). Arthritis was associated with clinically significant pain (OR 2.24, CI 1.91-2.63). Conclusions: Factors associated with common, burdensome symptoms in a national sample suggest clinical and population strategies for targeting symptom assessment and management.
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U2 - 10.1089/jpm.2015.0391
DO - 10.1089/jpm.2015.0391
M3 - Article
AN - SCOPUS:84990047465
SN - 1096-6218
VL - 19
SP - 1066
EP - 1073
JO - Journal of palliative medicine
JF - Journal of palliative medicine
IS - 10
ER -