Siddiqui, Mahwish Anjum (2021) An epidemiological study on the relationship between quality and quantity of social networks and chronic pain in older adults using data from the MOBILIZE Boston Study. PhD thesis, University of Greenwich.

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Abstract

Introduction: Pain is experienced amongst all ages of people. However, the pattern of its occurrence in older people is still not well understood. Existing evidence indicates that older adults are more susceptible to pain than other age groups. Moreover, the older adult population is now the fastest growing in the developed world, due to an increased life expectancy that is predicted to continue rising. There is evidence to suggest that social networks have a beneficial effect on the health and functional abilities of older people. Social networks, the support they provide, and engagement in social activities has been found to exert significant positive effects on the health and general functioning of older persons. In contrast, there is increasing evidence that socially isolated individuals have an increased risk of developing chronic conditions such as depression and impaired cognitive functions. It is therefore important that years lived are accompanied by a highly functional state of health. Understanding how this is achieved would have both individual and societal benefits, putting less economic burden on health care organisations and governments around the world.

Aim, objectives, and study hypothesis: This study aimed to explore if there is an association between social networks, social activities and chronic pain in community dwelling older adults. This was achieved by two overarching objectives, firstly by
reviewing the literature to identify if social networks play a protective role on pain outcomes in older community dwelling people; and secondly by analysing an existing dataset (the Mobilize Boston Study) that offered data on pain at baseline and at 18-months follow-up, along with data on structural social networks and social activity measures. It was hypothesised that the Mobilize Boston Study dataset would demonstrate social network and activity to be protective against pain outcomes (severity and interference).

Methods: Firstly, a review of literature was conducted and the included studies were analysed and synthesised using a narrative synthesis. Secondly, a secondary data analysis on self-reported measures of structural social networks, social activity and pain outcomes from the Mobilize Boston Study dataset, a prospective cohort study of 749 older adults aged 70 years and over, was conducted. Descriptive statistics were used to characterise the cohort at baseline. Chi-square statistics were conducted to categorise baseline cohort characteristics according to each social network and activity measure. Hierarchical regression models were run on baseline measures of social networks and activity, and pain outcomes, accounting for potential confounding covariates (e.g., socio-demographic and health factors). Longitudinal analysis using social networks and activity measures at baseline to predict pain outcomes at 18-months follow up was also conducted.

Results: The findings from the literature review concluded that social activity was related to better pain outcomes in older adults, however measures of perceived social support or structural social networks did not influence pain outcomes. The secondary data analysis demonstrated that the quantity of social networks did not play a role in predicting pain outcomes, whereas the social activity scores independently predicted lowered pain interference with daily activities, even after adjusting for potential
confounding factors such as age, sex, race, education, difficulty in mobility, and depression. For pain severity, neither quantity of social networks nor social activity scores demonstrated any significant associations. The relationship between baseline social network and social activity scores with pain interference and severity outcomes over 18 months did not generate statistical significance after accounting for health factors.

Conclusions: The results concluded that higher social activity predicts lower concurrent pain interference, but there was no evidence for the role of social networks on pain outcomes. Health variables such as depression were strongly related to pain
and significantly confounded the relationship between social networks and pain outcomes, both in severity and interference. This suggests that future research on pain should focus on qualitative aspects of social networks and pain in older adults, and in particular on older individuals free from depression. Aspects of social activity that make it protective for pain interference such as that defined by physical activity should be investigated further to confirm the findings of this research; nonpharmacological interventions designed to improve pain interference should focus on older adult’s social and physical activity.

Item Type:	Thesis (PhD)
Uncontrolled Keywords:	Pain, Older Adult, Social Network, Mobilize Boston Study,
Subjects:	R Medicine > RA Public aspects of medicine
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Health Sciences (HEA)
Last Modified:	13 Dec 2022 13:01
URI:	http://gala.gre.ac.uk/id/eprint/38252

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