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. 2013 Dec;61(12):2079-2086.
doi: 10.1111/jgs.12512. Epub 2013 Nov 1.

The mediating effect of chronic pain on the relationship between obesity and physical function and disability in older adults

Angela Fowler-Brown  1 , Christina C Wee  1 , Edward Marcantonio  1   2 , Long Ngo  1 , Suzanne Leveille  3
Affiliations

The mediating effect of chronic pain on the relationship between obesity and physical function and disability in older adults

Angela Fowler-Brown et al. J Am Geriatr Soc. 2013 Dec.

Abstract

Objectives: To determine the extent to which bodily pain mediates the effect of obesity on disability and physical function.

Design: Cross-sectional analysis.

Setting: Population-based sample of residents in the greater Boston area.

Participants: Community-dwelling adults aged 70 and older (N=736).

Measurements: Body mass index (BMI), obtained from measured height and weight, was categorized as normal weight (19.0-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese (≥30.0 kg/m2). Main outcome measures were the Physical Component Summary of the Medical Outcomes Study 12-item Short-Form Survey (PCS), activity of daily living (ADL) disability, and Short Physical Performance Battery (SPPB) score. Chronic pain was assessed according to the number of weight-bearing joint sites that had pain (hips, knees, feet and pain all over).

Results: Older obese adults had greater ADL disability and lower SPPB and PCS scores than their nonobese counterparts, although in sex-stratified adjusted analyses, obesity was adversely associated with outcomes only in women. Obesity was associated with greater number of pain sites; and more pain sites were associated with greater odds of disability. Mediation analysis suggests that pain is a significant mediator (22-44%) of the adverse effect of obesity on disability and physical function in women.

Conclusion: Bodily pain may be an important treatable mediator of the adverse effect of obesity on disability and physical function in women.

Keywords: disability; obesity; pain; physical function.

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Conflict of interest statement

Conflict of Interest: The authors have no financial or personal conflicts of interest related to this paper.

Figures

Figure 1
Figure 1
Model of the Potential Mediating Effect of Pain on the Relationship between Obesity and Disability and Poorer Physical Function
See this image and copyright information in PMC

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