MULTIMORBIDITY AND LONELINESS AMONG CANADIAN OLDER ADULTS: THE MEDIATING EFFECT OF PAIN PERCEPTION

Multimorbidity negatively affects the activities, lifestyle and quality of life of older persons causing complex interactions between physical and psychological conditions. These may make social interaction difficult, leading to potential feelings of loneliness. However, it is not known how the pathways between multimorbidity and loneliness could be modulated by the perception of pain. This study aimed to determine if an association exists between multimorbidity and loneliness and whether this association is mediated by pain perception. This cross-sectional study used data drawn from the 2008/2009 Canadian Community Health Survey, targeting persons aged ≥80 (n=6,427). Loneliness scale was derived by summing up responses to questions measuring loneliness (Hughes et al., 2004), multimorbidity was measured using an additive multimorbidity scale and pain was assessed with the HUPDPAD variable in CCHS. Ordinary least square regression analysis with six hierarchical blocks was used to estimate the relationships among multimorbidity, loneliness and pain variables. Multimorbidity expresses a statistically significant beta coefficient with the loneliness scale (β=0.092, p<0.001) in block 3, after controlling for age, sex, marital status, education and income. The inclusion of perceived pain in block 4 reduced the effect of multimorbidity on loneliness to β=0.049 (p<0.001). Inclusion of functional status in block 5 further reduced this association to β=0.043 (p=0.001). In this study, multimorbidity modestly increases the risk of loneliness among older persons as hypothesized, while perceived pain appears to slightly mediate this effect. Further study is needed to help clarify these associations using more refined measures and other sub-populations.