A cross-sectional study of factors associated with the number of anatomical pain sites in an actual elderly general population: results from the PainS65+ cohort

Figures & data

Figure 1 Body manikins used to define the 45 pain sites in the front and the back

Notes: Reproduced from Margolis RB, Tait RC, Krause SJ. A rating system for use with patient pain drawings. Pain. 1986;24(1):57–65. Available from: https://insights.ovid.com/pubmed?pmid=2937007. Promotional and commercial use of the material in print, digital or mobile device format is prohibited without the permission from the publisher Wolters Kluwer. Please contact [email protected] for further information.⁵³.

Figure 2 Preshaded manikins used to define the 23 APSs; each area of the same color corresponds to the same APS in the front and the back of the body.

Notes: Foot right (area 21 or 45 or both); foot left (area 22 or 44 or both); lower leg right (area 19 or 43 or both); lower leg left (area 20 or 42 or both); thigh right (area 17 or 41 or both); thigh left (area 18 or 40 or both); hand right (area 10 or 33 or both); hand left (area 11 or 32 or both); forearm right (area 8 or 31 or both); forearm left (area 9 or 30 or both); upper arm right (area 6 or 29 or both); upper arm left (area 7 or 28 or both); shoulder right (area 4 or 27 or both); shoulder left (area 5 or 26 or both); neck/throat (area 3 or 25 or both); head right (area 1 or 24 or both); head left (area 2 or 23 or both); stomach (area 14 or 15 or both); chest (area 12 or 13 or both); gluteal (area 38 or 39 or both); low back (area 36 or 37 or both); upper back (34 or 35 or both); genitals (area 16). Adapted from Margolis RB, Tait RC, Krause SJ. A rating system for use with patient pain drawings. Pain. 1986;24(1):57–65. Available from: https://insights.ovid.com/pubmed?pmid=2937007. Promotional and commercial use of the material in print, digital or mobile device format is prohibited without the permission from the publisher Wolters Kluwer. Please contact [email protected] for further information.⁵³
Abbreviation: APSs, anatomical pain sites.

Table 1 Distribution of sociodemographic characteristics and all studied variables in the whole sample (n = 6,611)a

Variables; mean (±SD), unless otherwise stated	Value
Age (n, %) (years)
65–69	1,957 (29.6)
70–74	1,442 (21.8)
75–79	1,333 (20.2)
80–84	1,068 (16.1)
≥85	811 (12.3)
Sex (n, %)
Male	3,057 (46.2)
Female	3,554 (53.8)
Civil status (n, %)
Single	366 (5.5)
Married	3,769 (57.0)
Divorced	977 (14.8)
Widowed	1,499 (22.7)
Education (n, %)
High school (secondary)	3,335 (52.3)
Upper secondary or vocational training	1,647 (25.8)
University	1,394 (21.9)
Total annual income (Euros)	2,4352 (±18,730)
NPS	5.0 (±4.9)
APS	1.9 (±2.8)
NRS7d	4.5 (±2.3)
Pain frequency (n, %)
Seldom	343 (9.2)
Sometimes	1,057 (28.3)
Often	1,303 (34.9)
Always/near always	1,031 (27.6)
Total GWBS	82.1 (±18.2)
EQ-5D-VAS	70.71 (±22.20)
Overall life satisfaction	7.3 (±2.2)
Consumption of painkillers (n, %)
No	1,528 (37.1)
Yes, but only occasionally	1,028 (25.0)
Yes, on several occasions but not every day	585 (14.2)
Yes, daily	978 (23.7)
Total number of comorbidities	1.9 (±1.5)

Note:

a Some of these results have also been reported in the study by Bernfort et al.³⁶

Abbreviations: APS, anatomical pain site; GWBS, General Well-Being Schedule; NPS, number of pain sites; SD, standard deviation; EQ-5D-VAS, the Euro Quality of Life Vertical Visual Analog Scale; NRS7d, pain intensity for the previous 7 days measured by numeric rating scale.

Figure 3 Distributions of the number of APSs categorized into 0, 1, 2, to 23 pain sites in males, females, and the total sample.

Notes: The y-axis represents the proportions of respondents (%). The x-axis represents the number of APSs categorized into 0, 1, 2 to 23 pain sites.
Abbreviation: APSs, anatomical pain sites.

Figure 4 Distributions of the location of the APSs in males and females.

Notes: The y-axis represents the proportions of respondents (%). The x-axis represents the anatomical pain sites for both sexes.
Abbreviation: APSs, anatomical pain sites.

Table 2 The total number of APSs and the location of the APSs in the whole sample

Number of APSs	n	%	Location of APSs	n	%
0	3,227	48.8	Foot right	770	11.6
1	835	12.6	Foot left	743	11.2
2	750	11.3	Lower leg right	948	14.3
3	504	7.6	Lower leg left	913	13.8
4	385	5.8	Thigh right	713	10.7
5	254	3.8	Thigh left	677	10.2
6	204	3.1	Hand right	632	9.5
7	132	2.0	Hand left	583	8.8
8	97	1.5	Forearm right	210	3.1
9	61	0.9	Forearm left	185	2.7
10	44	0.7	Upper arm right	303	4.5
11	30	0.5	Upper arm left	270	4.1
12	16	0.2	Shoulder right	782	11.8
13	17	0.3	Shoulder left	691	10.4
14	11	0.2	Neck/throat	724	10.9
15	16	0.2	Head right	268	4.1
16	4	0.1	Head left	252	3.8
17	10	0.2	Stomach	309	4.6
18	5	0.1	Chest	159	2.4
19	2	0.0	Gluteal	833	12.6
20	4	0.1	Low back	912	13.7
21	0	0.0	Upper back	231	3.4
22	0	0.0	Genitals	110	1.7
23	3	0.0

Abbreviation: APSs, anatomical pain sites.

Table 3 Results of regression analyses: cross-sectional associations of the factors associated with the number of APSs

Variables	Univariable model§			Multivariable model 1¤ (R^2 = 20%; p < 0.001)			Multivariable model 2§§ (R^2 = 21%; p < 0.001)
	Regression coefficients (B)	95% CI	p-value	Regression coefficients (B)	95% CI	p-value	Regression coefficients (B)	95% CI	p-value
Age (years)
65–69 (reference category)	–	–	–	–	–	–	–	–	–
70–74	0.07	−0.11, 0.27	0.410	−0.03	−0.30, 0.23	0.795	−0.05	−0.39, 0.28	0.755
75–79	0.20	0.01, 0.40	0.037	0.06	−0.21, 0.34	0.653	0.72	0.08, 1.36	0.025
80–84	−0.07	−0.28, 0.12	0.452	−0.49	−0.81, −0.16	0.003	−0.10	−0.83, 0.62	0.781
≥85	−0.09	−0.32, 0.12	0.397	−0.56	−0.94, −0.19	0.003	−0.03	−0.88, 0.80	0.931
Sex
Male (reference category)	–	–	–	–	–	–	–	–	–
Female	0.77	0.63, 0.90	<0.001	0.58	0.37, 0.79	<0.001	0.69	0.37, 1.01	<0.001
Civil status
Single (reference category)	–	–	–	–	–	–	–	–	–
Married	0.32	0.02, 0.62	0.031	0.78	0.35, 1.22	<0.001	1.00	0.42, 1.58	0.001
Divorced	0.20	0.01, 0.40	0.040	−0.02	−0.29, 0.25	0.874	0.03	−0.36, 0.43	0.874
Widowed	0.14	−0.01, 0.31	0.081	−0.13	−0.39, 0.13	0.337	−0.32	−0.79, 0.14	0.177
Education
Secondary (reference category)	–	–	–	–	–	–	–	–	–
Upper secondary or vocational training	0.04	−0.12, 0.20	0.628	–	–	–	–	–	–
University	−0.15	−0.33, 0.01	0.076	–	–	–	–	–	–
Total annual income	−0.01	−0.00, −9.17	<0.001	8.67	−5.51, 7.24	0.790	2.96	−4.57, 0.01	0.441
NRS7d	0.43	0.39, 0.47	<0.001	0.13	0.07, 0.18	<0.001	0.16	0.06, 0.23	<0.001
Pain frequency
Seldom (reference category)	–	–	–	–	–	–	–	–	–
Sometimes	1.77	1.43, 2.11	<0.001	1.18	0.74, 1.61	<0.001	1.09	0.44, 1.75	0.001
Often	2.99	2.66, 3.33	<0.001	1.92	1.47, 2.38	<0.001	1.91	1.23, 2.59	<0.001
Always/nearly always	4.05	3.71, 4.39	0.003	2.78	2.29, 3.27	<0.001	2.51	1.78, 3.24	<0.001
Total GWBS	−0.05	−0.05, −0.04	<0.001	−0.02	−0.02, −0.01	<0.001	−0.02	−0.03, −0.01	<0.001
EQ-5D-VAS	−0.05	−0.04, −0.03	<0.001	−0.02	−0.02, −0.01	<0.001	−0.02	−0.02, −0.01	0.001
Overall life satisfaction	−0.27	−0.30, −0.24	<0.001	0.02	−0.04, 0.08	0.513	0.04	−0.04, 0.14	0.306

Notes:

§ Each independent factor one at a time.

¤ Unadjusted multivariable analysis of all significant factors derived from univariable analysis together in one model, simultaneously controlled for.

§§ Multivariable analysis of the associations of multivariable model 1 adjusted for consumption of analgesics and the total number of comorbidities. Significant p-values are given in bold.

Abbreviations: APSs, anatomical pain sites; NRS7d, pain intensity for the previous 7 days measured by numeric rating scale; EQ-5D-VAS, the Euro Quality of Life Vertical Visual Analog Scale; B, unstandardized regression coefficients; R², multiple correlation coefficient squared; CI, confidence interval; GWBS, General Well-Being Schedule.

Table S1 Results of regression analyses: cross-sectional associations of the factors associated with the NPS (0–45)

Variables	Univariable model§			Multivariable model 1¤ (R^2 = 0.01; p = 0.598)			Multivariable model 2§§ (R^2 = 0.02; p = 0.608)
	Regression coefficients (B)	95% CI	p-value	Regression coefficients (B)	95% CI	p-value	Regression coefficients (B)	95% CI	p-value
Age (years)
65–69 (reference category)
70–74	–0.27	–0.73, 0.18	0.242	–0.55	–1.28, 0.18	0.141	–0.43	–1.37, 0.49	0.356
75–79	–0.11	–0.58, 0.36	0.646	–0.64	–1.43, 0.13	0.106	–1.32	–3.00, 0.36	0.125
80–84	–0.69	–1.20, –0.18	0.007	–1.15	–2.05, –0.26	0.011	–1.48	–3.55 0.58	0.161
≥85	–0.48	–1.05, 0.08	0.095	–0.90	–1.96, 0.14	0.092	–1.34	–3.65, 0.95	0.250
Sex
Male (reference category)
Female	0.06	–0.26, 0.40	0.682	–0.54	–1.14, 0.05	0.076	–0.85	–1.75, 0.03	0.061
Civil status
Single (reference category)
Married	0.20	–0.51, 0.92	0.578	–0.28	–1.51, 0.94	0.650	–0.13	–1.78, 1.52	0.877
Divorced	0.13	–0.34, 0.61	0.581	–0.06	–0.81, 0.68	0.866	0.05	–1.02, 1.13	0.917
Widowed	–0.05	–0.47, 0.35	0.783	0.09	–0.63, 0.83	0.797	0.08	–1.22, 1.40	0.898
Education
Secondary (reference category)
Upper secondary or vocational training	–0.01	–0.40, 0.38	0.962	–0.03	–0.65, 0.58	0.906	–0.37	–1.32, 0.58	0.443
University	–0.38	–0.81, 0.05	0.085	–0.49	–1.19, 0.21	0.171	–0.27	–1.37, 0.82	0.622
Total annual income	–3.81	–0.01, 7.80	0.520	–0.00	–0.00, 9.64	0.266	–0.00	–0.00, 0.82	0.166
NRS7d	–0.01	–0.10, 0.09	0.931	–0.02	–0.17, 0.12	0.753	0.12	–0.10, 0.35	0.282
Pain frequency
Seldom (reference category)
Sometimes	0.15	–0.72, 1.02	0.732	0.18	–1.04, 1.41	0.769	1.02	–0.77, 2.82	0.262
Often	0.38	–0.47, 1.23	0.382	0.40	–0.86, 1.68	0.531	0.82	–1.04, 2.69	0.385
Always/nearly always	–0.17	–1.05, 0.70	0.703	–0.12	–1.50, 1.25	0.861	0.07	–1.93, 2.07	0.945
Total GWBS	–0.01	–0.01, 0.01	0.265	–0.00	–0.02, 0.01	0.632	0.00	–0.03, 0.03	0.984
EQ-5D-VAS	0.01	0.00, 0.01	0.047	0.00	–0.01, 0.01	0.775	0.01	–0.00, 0.03	0.241
Overall life satisfaction	0.01	–0.05, 0.09	0.669	–0.01	–0.19, 0.16	0.849	–0.07	–0.35, 0.19	0.590

Notes:

§ Each independent factor one at a time.

¤ Unadjusted multivariable analysis of all factors together in one model, simultaneously controlled for.

§§ Multivariable analysis of the associations of multivariable model 1 adjusted for consumption of analgesics and the total number of comorbidities. Significant p-values are given in bold.

Abbreviations: CI, confidence interval; EQ-5D-VAS, the Euro Quality of Life Vertical Visual Analog Scale; NRS7d, Pain intensity for the previous 7 days measured by numeric rating scale; B, unstandardized regression coefficients; R², multiple correlation coefficient squared; GWBS, General Well-Being Schedule; NPS, number of pain sites.

MargolisRBTaitRCKrauseSJA rating system for use with patient pain drawingsPain198624157652937007

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BernfortLGerdleBRahmqvistMHusbergMLevinLÅSeverity of chronic pain in an elderly population in Sweden – impact on costs and quality of lifePain2015156352152725599240

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