DEMOGRAPHIC AND SOCIOECONOMIC RISK FACTORS FOR PAIN PROGRESSION AND RECURRENCE IN MIDDLE-AGED AND OLDER ADULTS - Abstract

Sep 28, 2026

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Chronic pain drives disability and lowers quality of life, especially among older adults, and often follows intermittent or progressive patterns with recurring episodes. This study evaluates which demographic and socioeconomic factors predict transitions between pain states—moderate-severe, mild, and no pain—using multistate models in 9,369 adults aged 50–98 from the English Longitudinal Study of Ageing (2002/03–2021/23). Results show gender and socioeconomic position shape pain trajectories: women are less likely to improve and more likely to recur. Higher education and wealth relate to faster improvement and reduced worsening and recurrence, supporting targeted access policies and systematic long-term follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Abstract

Background

Methods

Key Findings

Implications

484 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.1654 DEMOGRAPHIC AND SOCIOECONOMIC RISK FACTORS FOR PAIN PROGRESSION AND RECURRENCE IN MIDDLE-AGED AND OLDER ADULTS Mikaela Bloomberg, and Andrew Steptoe, University College London, London, England, United Kingdom Chronic pain is a major contributor to disability and reduced quality of life, particularly for older adults. Many pain conditions are also intermittent or progressive, with repeated episodes of pain worsening, subsiding, and recurrence. Identifying the demographic and socioeconomic factors that put individuals at risk of pain worsening or recurrence is therefore crucial for designing targeted early interventions and addressing disparities in pain management. Even so, the current evidence base is mixed and mostly uses methods that do not allow for nonlinear trajectories of pain. In this study, we used multistate models to examine demographic and socioeconomic risk factors for transitioning between pain states (moderate-severe, mild, or no pain) in 9,369 adults aged 50-98 years from the English Longitudinal Study of Ageing (study years: 2002/03-2021/23) . This approach allowed us to capture the dynamic and recurrent nature of long-term pain. Findings highlighted the importance of gender and socioeconomic position: for women (compared with men) pain was less likely to improve in severity (hazard ratio [HR]=0.84, 95% confidence interval=0.74-0.96) and more likely to recur (HR = 1.45, 1.25-1.68) . Higher education level was associated with pain improvement (HR=1.43, 1.16-1.76), and lower risk of pain worsening (HR = 0.52, 0.42-0.64) and recurrence (HR = 0.67, 0.52-0.85); similar patterns were observed for wealth. These results emphasise the variability of long-term pain over time and support policies aimed at improving access to pain management for women and individuals with fewer socioeconomic resources. The findings also point to the importance of systematic long-term follow-up of vulnerable groups to enable timely intervention.

FAQs

What is the study aiming to identify regarding chronic pain?

It identifies demographic and socioeconomic factors associated with increased risk of pain progression and pain recurrence across long-term follow-up.

How did the study model pain transitions over time?

Using multistate models to track transitions between pain states (moderate-severe, mild, and no pain) over the study period.

Which factors were linked to worse pain outcomes in this study?

Women had lower likelihood of pain severity improvement and higher likelihood of pain recurrence; lower socioeconomic position was also associated with greater risk of worsening and recurrence.

What do the findings suggest for intervention and policy?

They support targeted early interventions and improved access to pain management for women and individuals with fewer socioeconomic resources, along with systematic long-term follow-up of vulnerable groups.

Sep 28, 2026

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