The Multidimensional Experience of Noncancer Pain: Does Cognitive Status Matter?
Bibliographic record
Abstract
OBJECTIVE: Determine if the multidimensional pain-related experience differs between cognitively intact and impaired older adults. DESIGN: Cross-sectional analysis of the Canadian Study of Health and Aging. SETTING: Community-dwelling older adults. OUTCOME MEASURES: Pain reports were dichotomized from a 5-point scale into no/very mild vs moderate and greater. Cognition measured by the Modified Mini Mental State Exam (0-100) was dichotomized into cognitively intact (>77) and cognitively impaired (≤77). Five self-rated Instrumental Activities of Daily Living (IADL) were dichotomized into no impairment vs any impairment. The Mental Health Inventory consists of five self-rated questions about psychological state and well-being, with scores ranging from 0 to 30; scores >11 indicate depression. Self-rated health was dichotomized into very good/pretty good and not too good/poor/very poor. Additional covariates included demographics and co-morbidities. RESULTS: Of the 5,549 (97.3%) eligible participants, 1,991 (35.9%) reported pain of moderate intensity or greater, and 1,028 (18.5%) were cognitively impaired. Among cognitively impaired participants, moderate or greater pain report was associated with functional impairment odds ratio (OR) = 1.74 (1.15, 2.62; P < 0.01), depressed mood OR = 1.69 (1.18, 2.44; P < 0.01), and lower self-rated health OR = 2.35 (1.69, 3.30; P < 0.01). Among cognitively intact participants, pain report was similarly associated with functional impairment OR = 1.40 (1.20,1.63); P < 0.01), depressed mood OR = 1.88 (1.59,2.23; P < 0.01), and lower self-rated health OR = 2.34 (1.94,2.82; P < 0.01). CONCLUSIONS: Pain self-report in both cognitively intact and impaired community-dwelling persons is associated with a similar multidimensional experience. These findings confirm the need for comprehensive evaluation of pain and related outcomes in all older adults, with appropriate pharmacologic and nonpharmacologic management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".