Relationship between persistent pain and 5-year mortality: a population-based prospective cohort study.

Journal Article (Journal Article)


To assess the association between self-reported noncancer pain and 5-year mortality.




Community-dwelling older adults.


Canadian Study of Health and Aging 1996 wave.


Registrar of Vital Statistics-established 5-year mortality. Noncancer pain was assessed using the 5-point verbal descriptor scale, dichotomized into no or very mild versus moderate, severe, or very severe pain. Frailty was the accumulation of health deficits. Cognitive status (Modified Mini-Mental State Examination) and depressed mood (five-item mental health screening questionnaire) were also assessed. Multivariable logistic regression and Cox proportional hazards were used to analyze the relationship between pain and 5-year mortality.


Of 5,703 participants, 4,694 (82.3%) had complete data for analysis; 1,663 of these (35.4%) reported moderate, severe, or very severe pain, and 1,343 (28.6%) had died at 5-year follow-up. Four hundred ninety-six of those who died (29.8%) reported moderate, severe, or very severe pain and 847 (27.9%) no or very mild pain. Multivariate logistic analysis found that individuals with moderate, severe, or very severe pain had lower odds of 5-year mortality than those with no or very mild pain (odds ratio=0.78, 95% confidence interval (CI)=0.66-0.92; P<.001). The risk of death was lower in persons reporting moderate or greater pain than in those with no or very mild pain (HR=0.85, 95% CI=0.75-0.96; P=.01). An interaction between pain and sex explained this effect. Men with pain were not significantly more likely than men without pain to die (HR=1.00, 95% CI=0.84-1.19; P=.99), whereas women without pain (HR=0.54, 95% CI=0.47-0.63; P<0.01) and women with pain (HR=0.40; CI=0.33-0.47; P<.01) had less risk of death than men without and with pain, respectively.


Older women with pain were less likely to die within 5 years than older women without pain, men in pain, or men without pain.

Full Text

Duke Authors

Cited Authors

  • Shega, JW; Andrew, M; Kotwal, A; Lau, DT; Herr, K; Ersek, M; Weiner, DK; Chin, MH; Dale, W

Published Date

  • December 2013

Published In

Volume / Issue

  • 61 / 12

Start / End Page

  • 2135 - 2141

PubMed ID

  • 24320761

Pubmed Central ID

  • PMC4140782

Electronic International Standard Serial Number (EISSN)

  • 1532-5415

International Standard Serial Number (ISSN)

  • 0002-8614

Digital Object Identifier (DOI)

  • 10.1111/jgs.12554


  • eng