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Adherence to a Mediterranean Lifestyle and Changes in Frequency, Severity, and Localization of Pain in Older Adults

  • Mario Delgado-Velandia
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
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  • Rosario Ortolá
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
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  • Esther García-Esquinas
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
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  • Ellen A. Struijk
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
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  • Esther López-García
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain

    IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
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  • Fernando Rodríguez-Artalejo
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain

    IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
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  • Mercedes Sotos-Prieto
    Correspondence
    Correspondence: Address to Mercedes Sotos-Prieto, PhD, Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain.
    Affiliations
    Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain

    Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain

    IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain

    Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
    Search for articles by this author

      Abstract

      Objective

      To assess the association between adherence to a Mediterranean lifestyle and changes in pain, and its characteristics over time in older adults.

      Patients and Methods

      We analyzed data from 864 and 862 community-dwelling individuals aged 65+ years from the Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain (Seniors-ENRICA) Seniors-ENRICA-1 (2008–2010 to 2012) and Seniors-ENRICA-2 (2015–2017 to 2019) cohorts, with a median follow-up of 2.8 and 2.4 years, respectively. Adherence to a Mediterranean lifestyle was assessed at baseline with the 27-item Mediterranean lifestyle (MEDLIFE) index. Pain changes over time were calculated with a pain scale that assessed the frequency, severity, and the number of pain locations both at baseline and follow-up. Multivariable-adjusted relative risk ratios (RRRs) were obtained using multinomial logistic regression.

      Results

      In the pooled cohorts, after a median follow-up of 2.6 years, pain worsened for 697 participants, improved for 734, and did not change for 295. Compared with the lowest category of MEDLIFE adherence, those in the highest category showed an RRR of improvement vs worsening of overall pain of 1.85 (95% CI, 1.28 to 2.67; P-trend<.001). MEDLIFE adherence was also linked to improvement in pain frequency (RRR, 1.98; 95% CI, 1.31 to 3.01; P-trend=.001), pain severity (RRR, 2.00; 95% CI, 1.33 to 3.00; P-trend=.001), and a reduction in the number of pain locations (RRR, 1.68; 95% CI, 1.13 to 2.50; P-trend=.004). Limitations of this study are the use of self-reported lifestyle data.

      Conclusion

      A Mediterranean lifestyle was associated with improvement of pain characteristics in older adults. Experimental studies should assess the efficacy of an integral lifestyle approach for the management of pain in older adults.

      Abbreviations and Acronyms:

      BMI (body mass index), EPIC (European Prospective Investigation into Cancer and Nutrition cohort), Kcal (kilocalories), MEDLIFE (Mediterranean lifestyle index), RRR (relative risk ratio), SE1 (Seniors-ENRICA-1 cohort), SE2 (Seniors-ENRICA-2 cohort), Seniors-ENRICA (The Study on Nutrition and Cardiovascular Risk in Spain cohort)
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