Improvements in pain in older adults with arthritis may not be associated with improvements in 2 of 3 domains of disability, according to a study published in the British Journal of Health Psychology.

The cohort for this study — older English adults with arthritis (n=889) from the English Longitudinal Study of Ageing (ELSA) — were representative of the general population. Participants were tracked over 7 waves of the ELSA cohort, between 2002 and 2015, with interviews taking place every other year. The relationship between pain and functional disability was examined using 3 domains of disability: mobility, activities of daily living (ADL), and instrumental ADL (IADL). They compared the heterogeneous analysis of pain and disability with treating pain as a simpler, homogenous construct.

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Pain was found to be positively correlated with increased disability in all 3 domains of disability, a relationship that remained stable over time. Measures of disability were also found to correlate with age.

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At every wave of the ELSA cohort, the associations between pain and disability were strongest for mobility (mean correlation factor, r =.395) and weaker for ADL (mean r =.256) and for IADL (mean r =.210). Participants whose pain improved did not show improvement in ADL or mobility domains of disability.

“As such, clinicians should not simply reason that if patients report improving pain that they will also experience improvements in other aspects of their lives. Thus, if a patient reports their pain is getting better they may still require help with daily living and these services should remain in place,” noted the study authors.


James RJE, Walsh DA, Ferguson E. Trajectories of pain predict disabilities affecting daily living with arthritis. [published online April 7, 2019]. B J Health Psychol. doi:10.1111/bjhp.12364

This article originally appeared on Clinical Pain Advisor