Background: Little is known about the impact of pain on physical
functioning among the oldest-old subjects. In this study, we first examined
the associations between the number of painful sites and measures of
physical functioning reflecting different stages of the disablement process
(physical impairment, functional limitation and disability) among
nonagenarians (more than ninety years old persons). Second, we
described the effect of painful sites on disability during a 2-year follow-up
period.
Methods: This study is based on baseline (n = 1177) and 2-year
follow-up (n = 709) data of the nationwide Danish 1905 cohort study.
Musculoskeletal pain was assessed as reported pain in back, hips or knees
when moving or resting. Physical performance measures included
maximum grip strength and habitual walking speed. Disability in
performing activities of daily living was defined as the need for assistive
device or personal help in transferring, dressing, washing, using toilet
and/or walking indoors.
Results: At baseline, the number of painful sites was significantly
associated with measured grip strength and walking speed as well as
self-reported disability in a stepwise manner; the more sites with pain, the
poorer the physical functioning. The follow-up analyses showed
corresponding but slightly weaker stepwise associations between baseline
pain and disability level at follow-up, and indicated that although on the
whole, single or multi-site pain did not predict the onset of disability,
multi-site pain increased the risk of developing severe disability.
Conclusions: The findings of this study suggest that musculoskeletal pain
in nonagenarians is highly prevalent and is associated with poor physical
performance and disability.