(181) Trajectories of Bothersome Pain and Activity-Limiting Pain in a Population-Based Sample of Older Adults

Abstract

Little is known about longitudinal patterns of pain prevalence with aging. Identifying such patterns could allow for more targeted intervention. Our objective was to identify and describe long-term trajectories of bothersome pain and activity-limiting pain in a population-based sample of older adults. We conducted a retrospective cohort study of 6,783 community-dwelling participants using six years of longitudinal data from the National Health and Aging Trends Study (NHATS). NHATS is a cohort of older adults and is representative of Medicare Beneficiaries aged 65 years and older. NHATS data collection began in 2011, and demographic and health data are collected annually through in-person interviews. Outcomes were binary variables for bothersome pain in the past month and activity-limiting pain in the past month. We used group-based trajectory models to identify longitudinal patterns of bothersome pain and activity-limiting pain. We used weighted, multinomial logistic regression to describe associations with each group. The cohort was 57% female, 68% white, and 58% were ≥75 years. We identified four distinct trajectories for the probability of having bothersome pain over 6 years: consistently high (n=1901, 35%), increasing (n=898, 17%), decreasing (n=917, 17%), and consistently low (n=1735, 32%). Similar trajectories were identified for the probability of activity-limiting pain: consistently high (n=721, 13%), increasing (n=812, 15%), decreasing (n=677, 12%), and consistently low (n=3241, 60%). Number of comorbid health conditions was strongly associated with belonging to the consistently high versus low group for both bothersome pain [relative risk (RR)=1.78 increase for every additional condition; 95% CI: 1.67, 1.90)] and activity-limiting pain (RR=1.85 increase for every additional condition; 95% CI: 1.74, 1.98). Trajectories of bothersome pain and activity-limiting pain were highly variable. Approximately half of Medicare Beneficiaries have either high or increasing probability of long-term bothersome pain, and over a quarter have a high or increasing probability of activity-limiting pain long-term.