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. 2025 Aug 20:18:4187-4199.
doi: 10.2147/JPR.S526555. eCollection 2025.

Social Connection and Chronic Pain: A Cohort Study to Explore the Association of Social Isolation and Loneliness with Chronic Pain Among Older Adults in China

Xinru Han #  1 , Yiwei Qiao #  1 , Jialong Tan  1 , Zhi Luo  2 , Stephen Nicholas  3   4 , Elizabeth Maitland  5 , Lu Han  1 , Zhihao Xu  1 , Jian Wang  1   6
Affiliations

Social Connection and Chronic Pain: A Cohort Study to Explore the Association of Social Isolation and Loneliness with Chronic Pain Among Older Adults in China

Xinru Han et al. J Pain Res. .

Abstract

Background: As societies worldwide experience rapid aging, social isolation and loneliness are as prevalent and impactful on health outcomes of older adults as other well-recognized risk factors. This study investigates the association of social isolation and loneliness on the prevalence of chronic pain among Chinese older adults.

Methods: Participants from waves of the Chinese Health and Retirement Longitudinal Study (CHARLS) with no chronic pain in baseline 2011, and their conditions of chronic pain in wave 2018, were analyzed. The exposure factors were social isolation and loneliness. Social isolation was assessed by a comprehensive multi-factor measure, while loneliness and the outcome variable, chronic pain, were self-reported. The association of the exposure factors on the prevalence of chronic pain was conducted by logistic regression.

Results: Adults 60 years old and over who did not suffer from chronic pain at baseline in 2011 were enrolled, of whom 1669 participants (53.68%) developed chronic pain, and 1440 did not develop chronic pain, over a span of seven years. The results showed that social isolation (OR: 1.21, 95% CI: 1.01-1.45) and loneliness (OR: 1.61, 95% CI: 1.36-1.92) were associated with an elevated risk of chronic pain over seven years. It showed no statistically significant interaction associations between social isolation and feelings of loneliness.

Conclusion: Older adults with social isolation or loneliness tended to experience chronic pain, emphasizing the importance of incorporating social support and community engagement into chronic pain treatment strategies.

Keywords: chronic pain; cohort study; loneliness; social isolation.

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Conflict of interest statement

All authors declare no conflicts of interests. This paper has been uploaded to ResearchSquare as a preprint: https://www.researchsquare.com/article/rs-4550828/v1.

Figures

Figure 1
Figure 1
Flowchart of participants’ selection process.
Figure 2
Figure 2
Social isolation and loneliness association with chronic pain.
Figure 3
Figure 3
Social isolation and loneliness association with chronic pain: model 3.
Figure 4
Figure 4
Social isolation and chronic pain: Subgroup analysis.
Figure 5
Figure 5
Loneliness and chronic pain: Subgroup analysis.
See this image and copyright information in PMC

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