Pain over the adult life course: 15-year pain trajectories-The Doetinchem Cohort Study

Background: Pain at any age is related to pain experienced at younger ages, but not much is known on how pain develops over the adult life course. We studied long-term individual trajectories of pain over 15 years of the life course and evaluated the role of baseline sociodemographic factors, lifestyle factors and health characteristics.

Methods: Longitudinal data from the Doetinchem Cohort Study was used with 3,485 adults aged 25-71 years at baseline who were measured every 5 years, until the age of 40-86 years. Four measurements of self-reported pain were used to distinguish 15-year trajectories of pain, that were summarized in five pre-definedpatterns.

Results: The typical pain trajectory patterns were (prevalence): never pain (32.2%), persistent pain (19.5%), development of pain (19.2%), diminishing pain (11.1%) and fluctuating pain (18.0%). Multinomial logistic regression analyses showed that the trajectory characterized by never pain was more often found among: men, non-smokers, those reporting a normal sleep duration and those without obesity, chronic disease, a poor mental health, a poor perceived health, or musculoskeletal complaints.

Conclusions: A substantial part of the population reports pain over a long period of their life course and long-term trajectories of pain may reflect phenotypes that may be relevant to take into account in pain management. Several risk factors, such as short-sleep duration, smoking, obesity and poor perceived or mental health may be relevant in recognizing those with pain, and tackling these may contribute to the prevention of pain over the life course.

Significance: Asking adults about pain every 5 years over a 15-year period shows that almost one-third never reported pain and one-fifth persistent pain. "Persistent" and "developing" pain is associated with smoking, obesity and short sleep duration. Long-term pain trajectories may reflect relevant pain phenotypes.