Bothersome and activity-limiting pain in community-dwelling older adults with versus without stroke: a cross-sectional analysis of the National Health and Aging Trends study (2011-2024).

Abstract

Introduction: Stroke and pain are common health challenges among older adults. However, limited research has examined the burden of pain among community-dwelling older adults with a history of stroke in the United States of America (USA). This study aimed to estimate the prevalence of bothersome and activity-limiting pain and examine the association between stroke history and pain outcomes among older adults in the USA.

Materials and methods: This cross-sectional secondary analysis used publicly available data from Rounds 1-14 of the National Health and Aging Trends Study (NHATS), conducted from 2011 to 2024. The study included adults aged ≥ 65 years and compared participants with and without a self-reported physician-diagnosed history of stroke. Pain outcomes were derived from standardized NHATS interview data and included bothersome pain and activity-limiting pain. Demographic, clinical, psychological, physical, and sleep-related variables were obtained from the NHATS dataset. Survey-weighted multivariable logistic regression was used to examine the associations between stroke history and pain outcomes after adjustment for relevant covariates.

Results: Among 12,797 participants, 2,235 (15.71%) had a history of stroke, and 10,562 (84.29%) did not. The prevalence of bothersome pain was higher among participants with stroke than among those without stroke (60.77% vs. 54.66%; p = .003). Similarly, activity-limiting pain was more prevalent among participants with stroke (62.83% vs. 52.00%; p < .001). After adjustment for demographic, clinical, psychological, physical, and sleep-related factors, stroke remained independently associated with bothersome pain (OR 1.30, 95% CI 1.02-1.66; p = .034) and activity-limiting pain (OR 1.20, 95% CI 1.04-1.38; p = .013).

Conclusions: Pain represents a substantial burden among U.S. older adults with a history of stroke. Stroke was independently associated with both bothersome and activity-limiting pain, highlighting the importance of comprehensive pain assessment and management within geriatric stroke rehabilitation.