Physical inactivity is the most important unhealthy lifestyle factor for pain severity in older adults with pain: A SHARE-based analysis of 27,528 cases from 28 countries
Musculoskeletal Science and Practice
Volume 76, April 2025, 103270
Rodrigo Núñez-Cortés
Highlights
- Physical inactivity had the highest odds ratio for severe pain in older adults.
- Sleep issues, smoking, and poor diet were linked to pain but less strongly than inactivity.
- Targeting modifiable lifestyles can help manage pain and promote healthy aging.
Abstract
Background
Limited knowledge exists on the association between lifestyle factors and pain severity in older adults.
Objective
To assess the associations between unhealthy lifestyle variables and pain severity in the European population of older adults with pain.
Design
Cross-sectional.
Methods
Data were retrieved from the ninth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), a representative survey of individuals aged >50 years living in 27 European countries and Israel. Associations between lifestyle factors (sleep, smoking, diet and physical inactivity) and pain severity (mild, moderate, severe) were assessed using multivariable multinomial regression adjusted for age, sex, geographic region, education, history of chronic disease and mutually adjusted for each lifestyle.
Results
27,528 cases were included (73.1 ± 9.76 years; 63.3% female). A significant association was observed between those who hardly ever or never engaged in activities that required a moderate level of energy and severe pain (OR: 4.35; 95% CI: 3.85 to 4.92). Sleep problems (OR: 1.83; 95% CI: 1.69 to 1.99), smoking (OR: 1.21; 95% CI: 1.13 to 1.34) and an inadequate diet (OR: 1.78: 95% CI: 1.22 to 2.61) were also significantly associated with severe pain, but with lower odds. Given the cross-sectional design, the bidirectionality of these relationships should be considered.
Conclusion
Physically inactive older adults were particularly more likely to experience severe pain, while other lifestyle factors were more weakly associated with pain. As these lifestyle factors are modifiable, the results may be useful in prioritising appropriate preventive measures to attenuate pain and ensure healthy ageing.