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Chronic physical illness in early life and risk of chronic widespread and regional pain at age 68: evidence from the 1946 British birth cohort

Muthuri, Stella G.; Kuh, Diana; Bendayan, Rebecca; Macfarlane, Gary J.; Cooper, Rachel

doi: 10.1097/j.pain.0000000000000663
Research Paper

This study aimed to examine the associations between serious illness in earlier life and risk of pain in old age using data from a large nationally representative British birth cohort, the Medical Research Council (MRC) National Survey of Health and Development (NSHD). Serious illness was defined as any experience of illness before age 25 requiring hospital admission of ≥28 days. Pain was self-reported at age 68, with chronic widespread pain (CWP) defined according to American College of Rheumatology criteria. Multinomial logistic regression was used to test associations of serious illness in early life with CWP, chronic regional pain (CRP), and other pain, with no pain as the referent category. Adjustment was made for sex, socioeconomic position, adult health status, health behaviours, and psychosocial factors. Of 2401 NSHD participants with complete data, 10.5% reported CWP (13.2% of women and 7.7% of men), 30.2% reported CRP, and 14.8% other pain. Compared with those with no history of serious illness, those who experienced serious illness in early life had a higher likelihood of CWP (relative risk ratio [RRR] = 1.62 [95% CI: 1.21-2.17]) and of CRP (RRR = 1.25 [95% CI: 1.01-1.54]) after adjusting for sex. In fully adjusted models, serious illness in early life remained associated with CWP (RRR = 1.43 [95% CI: 1.05-1.95]), but associations with CRP were attenuated (RRR = 1.19 [95% CI: 0.96-1.48]). There were no associations with other pain. These findings suggest that those who have experienced serious illness in earlier life may require more support than others to minimise their risk of CWP in later life.

Supplemental Digital Content is Available in the Text.In a British birth cohort study, experience of serious illness in earlier life is associated with increased risk of chronic widespread pain at age 68.

aMRC Unit for Lifelong Health and Ageing, UCL, London, United Kingdom

bEpidemiology Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom

cAberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, United Kingdom

Corresponding author. Address: MRC Unit for Lifelong Health and Ageing, UCL, 33 Bedford Place, London WC1B 5JU, United Kingdom. Tel.: +44 (0) 20 7670 5711; fax: +44 (0) 20 7580 1501. E-mail address: (S. G. Muthuri).

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This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received May 09, 2016

Received in revised form June 24, 2016

Accepted July 05, 2016

© 2016 International Association for the Study of Pain