Pain and fatigue in persons with postpolio syndrome: independent effects on functioning.

ABSTRACT

OBJECTIVES: To better understand the importance of pain and fatigue in relation to functioning, and to investigate the role that age plays in these relationships in individuals with postpolio syndrome (PPS). DESIGN: Cross-sectional survey. SETTING: Community-based survey. PARTICIPANTS: Convenience sample of 446 individuals with PPS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physical functioning (Patient Reported Outcomes Measurement Information System Physical Functioning item bank items), psychological functioning (Patient Health Questionnaire-9), pain intensity (0-10 numerical rating scale [NRS]), and fatigue (0-10 NRS). RESULTS: Pain and fatigue make independent contributions to the prediction of physical and psychological functioning. Depression was more severe in the middle-aged (≤64y) group than in the young-old (65-74y) or middle-old to oldest (≥75y) groups, although the associations between pain and fatigue and both physical and psychological functioning are similar across all age cohorts. CONCLUSIONS: Complaints of pain or fatigue in patients with PPS who are older or elderly should not be attributed "merely" to the process of aging. The findings also support the need for clinical trials to develop and evaluate interventions that may help patients with PPS function better by treating pain and fatigue, as well as the negative effects that these symptoms can have on functioning.