Session Type: Abstract Submissions (ACR)
Background/Purpose: Population studies indicate that older persons experience more pain generally. Fibromyalgia (FM) affects persons of all ages, with previous studies on the impact of age on symptom severity reporting conflicting findings. Jiao et al. reported worse symptoms for younger patients 1 , whereas Cronan et al. reported that increasing age was associated with reduced FM symptomatology2. The aim of this analysis was to describe the association between age at FM diagnosis and patient and clinical characteristics among Canadian patients in routine clinical care.
Methods: A cohort of FM patients prospectively followed at a tertiary care multidisciplinary clinic was included in the analysis. Demographic and disease severity measures included: pain visual analog scale (VAS), patient global assessment (PGA), Health Assessment Questionnaire (HAQ), Pain Disability Index (PDI), Pain Catastrophizing Scale (PCS), FIQ, MPQ, anxiety and depression by Arthritis Impact Measurement Scale (AIMS). General linear models and logistic regression were used to assess the association between age and, continuous or categorical, respectively, patient or disease parameters at baseline.
Results: The cohort comprised 248 patients with a mean ± SD age 47.89 ± 10.34 years, disease duration 10.84 ± 9.80 years, and 91.13% female. Baseline values were: pain VAS 6.52 ± 2.29, PGA 6.58 ± 2.23, FIQ 66.97 ± 16.82, HAQ 1.19 ± 0.61, MPQ 40.82 ± 15.22, PDI 37.69 ± 14.44, PCS 29.39 ± 12.17, AIMS anxiety 6.34 ± 1.84, AIMS depression 4.91 ± 1.84, with a mean medication count of 2.38 ± 1.67 per patient.
Increased age was associated with significantly (P<0.001) longer pain duration (B=0.34; i.e. increased duration of pain by 0.34 years for each additional year of age) and lower odds of having allodynia (OR=0.97; P=0.037). Furthermore, increased functional disability was observed in older patients as evidenced by the higher HAQ scores (B=0.01; P=0.007). However, no significant association was observed with pain severity, PDI, PCS, PGA, FIQ, MPQ, anxiety and depression. Older patients were more likely to be treated with tranquilizers (OR=1.03; P=0.039), with a statistical trend towards more analgesics (OR=1.03; P=0.096) but less antidepressant use (OR=0.98; P=0.091). No significant differences were observed for other treatments, cigarette smoking, or substance abuse.
Conclusion: Although older age at baseline was associated with significantly longer duration of pain, no significant differences in disease parameters were observed based on age; the only exception being HAQ which was worse among older patients. Patient management differed based on age without, however, reaching statistical significance. Further study is necessary to establish whether response to treatment is associated with age.
1. Jiao J, Vincent A, Cha SS, et al. Relation of age with symptom severity and quality of life in patients with fibromyalgia. Mayo Clin Proc 2014;89:199-206.
2. Cronan TA, Serber ER, Walen HR, Jaffe M. The influence of age on fibromyalgia symptoms. J Aging Health 2002;14:370-84.
M. A. Fitzcharles,
P. A. Ste-Marie,
J. S. Sampalis,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-age-on-symptom-severity-and-disease-management-at-fibromyalgia-diagnosis/