Is pain catastrophizing associated with poor mobility performance and falls in older adults?

Background: Pain catastrophizing has been associated with pain intensity and mobility limitations in adults, and may be associated with mobility problems among older adults with chronic pain. This study examined the associations between pain catastrophizing and pain characteristics, and physical performance in older people.

Methods: The MOBILIZE Boston Study II (MBS) included 354 adults aged ≥70 years, living in the Boston area, originally enrolled in the MBS I from 2005-2008. Pain catastrophizing was measured using the 13-item Pain Catastrophizing Scale (PCS), with scores ranging from 13-65. Pain severity and pain interference were assessed by subscales of the Brief Pain Inventory. Pain distribution was classified as none, single site, and multisite. Mobility performance was assessed using the Short Physical Performance Battery (SPPB). Falls were assessed prospectively using monthly fall calendar postcards.

Results: One-fourth of all participants (24 %) had high scores on the PCS (score>30). PCS was inversely associated with age and was greater among those with osteoarthritis, depression, or anxiety (p-value<0.05). PCS score was associated with global measures of pain including pain severity (p-value = 0.01), pain interference (p-value = 0.004) and multisite pain compared to no pain (p-value = 0.006). After adjusting for confounders, PCS was not associated with mobility and fall in this older population.

Conclusion: Although pain catastrophizing is prevalent in older adults with chronic pain, it was not associated with mobility or falls in older people. Further research is needed to determine possible long-term effects of pain catastrophizing on chronic pain and functioning in older adults.