Persistent, Consistent, and Extensive: The Trend of Increasing Pain Prevalence in Older Americans

Assess trends in pain prevalence from 1992 to 2014 among older U.S. adults and by major population subgroups, and test whether the trends can be explained by changes in population composition.

Health and Retirement Study data include information on any pain, pain intensity, and limitations in usual activities due to pain. Average annual percent change in prevalence is calculated for any and for 2 levels of pain-mild/moderate and nonlimiting and severe and/or limiting-across demographic and socioeconomic characteristics, and for those with and without specific chronic conditions. Generalized linear latent and mixed models examine trends adjusting for covariates.

Linear and extensive increases in pain prevalence occurred across the total population and subgroups. The average annual percent increase was in the 2%-3% range depending upon age and sex. Increases were consistent across subgroups, persistent over time, and not due to changes in population composition. Without increases in educational attainment over time, pain prevalence increases would be even higher.

The increases in pain prevalence among older Americans are alarming and potentially of epidemic proportions. Population-health research must monitor and understand these worrisome trends.