Which is More Predictive of Mortality-Pain Severity or Pain Interference? Evidence from 20-Year Longitudinal Data

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Chronic pain significantly impacts quality of life and healthcare costs.
• Existing research on pain and mortality is inconsistent, with limited focus on pain interference.
• Sociodemographic variations in the pain-mortality link are understudied.

Purpose of the Study:

• To determine if pain severity or pain interference is a stronger predictor of all-cause mortality in U.S. adults aged 51+.
• To investigate if these associations differ across race/ethnicity, socioeconomic status, and sex.

Main Methods:

• Longitudinal analysis of 20 years of data (1998-2018) from the Health and Retirement Study (N=19,487).
• Cox proportional hazards models were used to estimate mortality risk.
• Multiplicative interaction terms assessed sociodemographic heterogeneity.

Main Results:

• Pain severity was not significantly associated with mortality risk in adjusted models.
• Pain interference was significantly associated with increased mortality risk (HR: 1.33; 95% CI: 1.27-1.39).
• Associations between pain interference and mortality showed minimal variation across race/ethnicity, sex, education, and wealth.

Conclusions:

• Pain interference is a more potent predictor of mortality than pain severity in older adults.
• Clinicians should assess and address pain interference to identify mortality risk.
• Interventions targeting functional limitations due to pain may enhance longevity.