Pain and disability transitions among older Americans: The role of education

  • Feinuo Sun
    Corresponding author: Feinuo Sun, Global Aging and Community Initiative, Level 2, McCain 201C, Mount Saint Vincent University, 166 Bedford Hwy, Halifax, NS, B3M 2J6.
    Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
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  • Zachary Zimmer
    Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.

    Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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  • Anna Zajacova
    Department of Sociology, University of Western Ontario, London, Ontario, Canada
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Published:January 23, 2023DOI:


      • Pain predicts the development of functional limitation and disability after one year.
      • Pain decreases the chances of recovery from functional limitation or disability.
      • Education cannot prevent the onset of functional limitation and disability for those with pain.
      • Education facilitates the recovery from functional limitation or disability for those with pain.


      Previous literature has rarely examined the role of pain in the process of disablement. We investigate how pain associates with disability transitions among older adults, using educational attainment as a moderator. Data are from the National Health and Aging Trends Study, N=6,357; 33,201 one-year transitions between 2010-2020. We estimate multinomial logistic models predicting incidence or onset of and recovery from functional limitation and disability. Results show pain significantly predicts functional limitation and disability onset one year after a baseline observation, and decreases odds of recovery from functional limitation or disability. Contrary to expectations, higher education does not buffer the association of pain in onset of disability, but supporting expectations, it facilitates recovery from functional limitation or disability among those with pain. The analysis implicates pain as having a key role in the disablement process and suggests that education may moderate this with respect to coping with and subsequently recovering from disability.


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