Older Adults With Low Activity Level at Increased Risk for Developing High Impact Pain

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Study authors sought to capture the relationship between pain and level of physical activity in older adults.

Higher impact pain was associated with engaging in low levels of moderate intensity exercise among older individuals. These findings, from a longitudinal study, were published in the European Journal of Pain.

Researchers from the University of Limerick analyzed data from The Irish Longitudinal Study on Ageing (TILDA), which sampled adults aged 50 years or older for their socio-demographic status, health, physical activity, and pain status in 3 waves (2010, 2012, and 2014).

During each wave of the study, participants reported relatively consistent levels of physical activity, in which ~33% of respondents indicated they had low, moderate, and high levels of physical activity. Individuals who reported a low level of activity tended to be older and women who had poorer mental or physical health.

The majority of adults (66%) did not report pain, 16% to 18% reported having low-level pain, and 16% to 18% reported high impact pain. The probability maintaining their pain group status over time was least likely for the intermediate pain group (0.53-0.55) and more likely for the no pain (0.85) or high pain (0.85-0.87) cohorts.

Compared with individuals who had a high level of physical activity, those with moderate (odds ratio [OR], 1.59; 95% CI, 1.27-1.99) and low (OR, 4.00; 95% CI, 3.21-5.17) levels of activity were at increased risk for high impact pain.

Among only individuals with moderate or low physical activity who reported no pain during wave 1, they were at increased risk for transitioning to high impact pain during wave 2 (OR, 1.90; 95% CI, 1.15-3.37) and wave 3 (OR, 2.27; 95% CI, 1.40-4.74). Other exercise or pain groups were not at increased risk for transitioning to high impact pain.

This study may have been limited by its short follow-up time and by its categorical definitions of physical activity and pain.

These data indicated physical activity among older adults was associated with socio-demographic features, physical and mental health status, and with future transition to high impact pain. Without the benefit of exercise, older adults are at a higher risk of developing comorbidities such as depression, anxiety, hypertension, diabetes, heart disease, cancer, lung disease, osteoporosis, stroke, and arthritis. Therefore, the study authors concluded older adults who cannot meet the minimum physical activity guidelines were at increased risk for developing some type of high-impact pain.


O’Neill A, O’Sullivan K, McCreesh K. Lower levels of physical activity are associated with pain progression in older adults, a longitudinal study. Eur J Pain. Published online March 8, 2021. doi:10.1002/ejp.1759.