Prevalence and impact of pain among older adults in the United States: findings from the National Health and aging trends study

In view of the large numbers of older adults with multiple morbidities, hospitalizations and surgical procedures, there is a critical need to assess the burden of pain in the older adult population. The current study sought to determine the prevalence and impact of pain in a nationally representative sample of older adults in the United States (US). Data from the 2011 National Health and Aging Trends Study were analyzed. In-person interviews were conducted in 7,601 adults ages >=65 years. The response rate was 71.0% and all analyses were weighted to account for the sampling design. The overall prevalence of bothersome pain in the last month was 52.9%, afflicting 18.7 million older adults in the US. Pain did not vary across age groups (p=0.21) and this pattern remained unchanged when accounting for cognitive performance, dementia, proxy-responses, and residential care living status. Pain prevalence was higher in women and in older adults with obesity, musculoskeletal conditions, and depressive symptoms (p<0.001). The majority (74.9%) of older adults with pain endorsed multiple sites of pain. Several measures of physical capacity, including grip strength and lower extremity physical performance, were associated with pain and multisite pain. For example, self-reported inability to walk 3 blocks was 72% higher in participants with than without pain [adjusted Prevalence Ratio=1.72 (95% Confidence Interval: 1.56-1.90)]. Participants with 2, 3, and >=4 sites of pain had gait speeds that were 0.03, 0.05, and 0.08 meters per second slower, respectively, than older adults without pain, adjusting for disease burden and other potential confounders (P<0.001). In summary, bothersome pain in the last month was reported by half of the older adult population of the US in 2011 and was strongly associated with decreased physical function.