All ETDs from UAB

Advisory Committee Chair

Gerald McGwin

Advisory Committee Members

Smita Bhatia

Grant R Williams

Document Type


Date of Award


Degree Name by School

Master of Science (MS) School of Public Health


Purpose: The impact of pain on functional status and mental health among older adults with cancer is a relevant, yet understudied issue. Our aim of this study sought to identify prevalence of pain at diagnosis in older adults with cancer and evaluate the association with functional status limitations, cognition, and mental health issues. Methods: This study included patients diagnosed with cancer at age ≥60 enrolled in the CARE Registry at University of Alabama at Birmingham. Patients completed a patient-reported geriatric assessment at the time of their initial visit with a medical oncologist. Pain measured in numeric rating scale from 0-10. We utilized the literature based cut off for moderate-severe as ≥4. Logistic regression modeling used to assess differences in functional status, falls, cognitive complaints, and depression/anxiety associated with moderate/severe pain, adjusted for sex, race, education, ethnicity, marital status, cancer type/stage, and treatment phase. Results: Our cohort included 714 older adults with a median age of 70 years (standard deviation of 6.8) and 59% male. Most common diagnoses included colorectal (27.9%), pancreatic (18%), gastroesophageal (6.4%), hepatobiliary (11.5%), and others (36.3%). Pain self-reported as none/mild (0-3) =56.7% and moderate/severe (4-10) = 43.3%. In univariate analyses, Black patients, lower education, disabled employment, and pancreatic cancer was associated with increased moderate/severe pain. After multivariate iv adjusting for covariates, older participants with self-reported moderate/severe pain were more likely to report limitations in instrumental activities of daily living (aOR 4.3 95% confidence interval [CI] 3.1-6.1, p

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