December 2015

Updates from TRIPLL:

The Translational Research Institute on Pain in Later Life (TRIPLL) is an NIH funded Edward R. Roybal Center. Our eNewsletter features recent news, events and funding opportunities related to pain and aging. In this issue we highlight a newly developed algorithm for treatment of depression in older adults with chronic pain, as well as research on aquatic exercise for pain relief, and the relationship between pain and functional independence of older adults following acute illness or injury.
In This Issue
RECENT RESEARCH
A diagnosis and treatment algorithm for depression in older adults with back pain 

In the fourth article of a series on treatment for chronic lower back pain, Carley et al. present an algorithm they have developed for physicians to both assess and treat depression in older adults with chronic lower back pain (CLBP). A number of studies suggest that depression is very common in older adults, and may heighten not only the severity of CLBP, but also the extent to which it is disabling. Employing a modified Delphi Technique, expertise from a panel of geriatricians, psychiatrists and primary care physicians was developed into a treatment plan for older adults with CLBP who may have comorbid depression. Additionally, the researchers concluded that primary care physicians should screen for depression in older adults with CLBP. Because depression in older adults with CLBP may accompany other comorbid psychiatric issues, ranging from alcoholism to anxiety disorders or dementia, the algorithm stresses a multidisciplinary approach to treating depression in older adults with pain, where cognitive behavioral therapy can be implemented in tandem with "first line" pharmacological treatments for depression. Ultimately, patients in this population will likely benefit when pain is not treated in isolation from psychiatric issues like depression. 

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Translating aquatic exercise for pain relief in older adults with osteoarthritis 

Degenerative joint diseases like osteoarthritis are prevalent among older adults. While exercise is often recommended to patients as a strategy for pain management, land-based exercises may place strain on joints, exacerbating symptoms. Alternatively, pool-based, aquatic exercise reduces the amount of strain placed on joints and may play a pain management role for older adults with osteoarthritis. In a recent article published in the Therapeutic Recreation Journal, researchers reviewed literature on aquatic exercise and osteoarthritic pain in older adults. In all five interventional studies reviewed, researchers found that aquatic exercise decreased pain. Additionally, one study found that aquatic exercise decreased pain-related disability and three of the five interventions found that it increased quality of life. However, because the benefits from aquatic exercise may not be sustained over a longer period of time, aquatic exercise might be best suited as one component of a multidisciplinary approach to pain management. The authors suggest that recreational therapists should implement programs of exercise three times a week and stress the importance of safety measures for older adults (e.g., handrails, non-slip surfaces), noting that high intensity aerobics in warm water may be contraindicated in individuals with cardiopulmonary disorders. 

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Pain is related to functional independence during and after  rehabilitation

A recent study published by the Journal of the American Geriatrics Society explores the relationship between pain and functional independence in older adults, following "acute illness or injury," during and after rehabilitation. In this prospective study, researchers Rodriguez et al. followed a group of 245 older adults through the rehabilitation process, measuring pain and functional independence. These measures were collected from patients at admission to, and discharge from, rehab, as well as at three, six and nine month follow-up. In applying bivariate analyses to the collected data, the amount of pain at discharge, as well as persistent pain, were not found to be significant predictors of functional independence at nine months post-rehab. However, a multilevel modeling approach reveals that when individuals report greater pain than they usually do, their functional independence score is significantly worse. The authors hope that future studies will elucidate whether reducing pain in the rehab and post-rehab setting results in less disability and more functional independence. 

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UPCOMING EVENTS
TRIPLL Work in Progress Seminar

Date: Friday, January 22, 2016
Time: 12:00 PM - 1:30 PM
Location: Call 212-746-7362

Monthly TRIPLL Work in Progress (WIP) seminars are primarily devoted to reviewing and critiquing grant proposals prior to submission. Seminars serve as a "mini-study section," where proposals are carefully reviewed in advance by seminar attendees and interdisciplinary feedback is given to the presenter. Presenters circulate their materials one week in advance of the seminar to allow group members to carefully review the work. WIP seminars have helped enhance the grant-writing skills of investigators who have gone on to obtain federal and nonfederal funding. If you are interested in learning more about our WIP Seminars, please contact Zachary Goodman at zsg2001@med.cornell.edu.

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TRIPLL mHealth & Pain Webinar Series: Jennifer Stinson

Date:  Monday, January 25, 2016
Time: 3:00 PM - 4:00 PM

Title: One size doesn't fit all: Personalized digital health approaches to chronic disease management 
Presenter Jennifer Stinson, RN-EC, PhD, CPNP, The Hospital for Sick Children

Overview: One in five Canadian children and youth will suffer from recurrent or chronic pain. Many children with chronic pain do not have access to an integrated care approach, which encompasses multiple treatment modalities (pharmacological, physical and psychological) to address the multifaceted nature of this condition. The use of digital health technologies has facilitated access to appropriate and time care. Dr. Stinson will provide examples of web and smartphone based applications for the assessment and management of chronic pain in children, and discuss how this research has applications for the management of pain in older adults.  

Click here  to registe r for this  free webinar. 
Translating Developmental Neuroscience into Multimodal Treatments for Chronic Pain

Date/Time: 
Saturday, January 9 from 9:30 am - 6:00 pm & Sunday, January 10 from 10:00 am - 5:10 pm  
Location: New York State Psychiatric Institute; At Columbia University Medical Center; Hellman Auditorium, 1st floor, 1051 Riverside Drive, New York, NY 10032

An international group of leading psychosomatic researchers and clinicians will present the science and clinical approaches to multimodal emotion, body, and development-focused treatments for central chronic pain. A multidisciplinary community of psychosomatic clinicians and researchers, psychiatrists, psychologists, neurologists, nurses, primary care, pain, internal medicine, and family physicians, social workers, art, music, dance/movement, and body-psychotherapists, physical therapists, as well as clinical and basic researchers take part in this exchange on cutting-edge psychosomatic treatments and research on centrally-modulated chronic pain.

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RECENT PAIN AND AGING RELATED FUNDING
Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care (R01)
 
NIH
Funding Amount: Variable
Due Date:
Standard dates  apply, by 5:00 PM local time of applicant organization.
 
This funding opportunity announcement (FOA) seeks Research Project Grant (R01) applications that propose to use a common conceptual model to develop behavioral interventions to modify health behaviors and improve health outcomes in patients with comorbid chronic diseases and health conditions. Specifically, this FOA will support research in primary care that uses a multi-disease care management approach to behavioral interventions with high potential impact to improve patient-level health outcomes for individuals with three or more chronic health conditions. The proposed approach must modify behaviors using a common approach rather than administering a distinct intervention for each targeted behavior and/or condition. Diseases and health conditions can include, but are not limited to: mental health disorders (e.g., depression), diabetes, smoking, obesity, chronic pain, alcohol and substance abuse and dependence, chronic obstructive pulmonary disorder, cancer and hypertension.

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Secondary Analyses of Existing Data Sets and Stored Biospecimens to Address Clinical Aging Research Questions (R01) 
 
NIH/NIA
Funding Amount: Variable
Due Date: Standard dates apply, by 5:00 PM local time of applicant organization.

This funding opportunity announcement (FOA) invites applications employing secondary analysis of existing data sets or stored biospecimens, to address clinically-related issues on aging changes influencing health across the life span, and/or on diseases and disabilities in older persons. This FOA will support activities addressing specific hypotheses in clinical aging research and/or to inform the design and implementation of future epidemiologic or human intervention studies, or current geriatric practice in maintenance of health, management of disease, and prevention of disability. Existing data sets may also be used to develop and test new statistical analytical approaches. Costs for archiving of data to be made publicly available may be included in the budget, as long as the archival activities are pertinent to the proposed secondary analyses.  

Click here for more information. 
We welcome your feedback about what you would like included in future eNewsletters. 
Email suggestions and news items to zsg2001@med.cornell.edu.

  

The Translational Research Institute on Pain in Later Life (TRIPLL) is an
NIA funded Edward R. Roybal Center with a focus on persistent pain due to both cancer and non-cancer related causes. TRIPLL is a collaboration between investigators at Weill Cornell Medical College, Cornell University in Ithaca and The Hebrew Home at Riverdale.