Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers

Disabil Health J. 2014 Oct;7(4):457-65. doi: 10.1016/j.dhjo.2014.05.001. Epub 2014 May 10.


Background: Older adults' function level can be used as a predictor of future detrimental events, such as disability, reliance on others, risk of institutionalization and likelihood of death. The assessment of function at the primary health care centers using self-reported and/or performance based measures is of prime importance.

Objective: To determine whether personal factors, pain, depression and physical activity are associated with self-reported and performance based disability for older adults aged ≥ 60 years attending primary health care centers, as measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and Short Physical Performance Battery (SPPB), respectively.

Methods: Participants (196 females and 55 males; mean age ± SD = 70.87 ± 7.76) had their pain, self-reported disability, performance, physical activity levels and depressive symptoms assessed. Regression analyses were performed with self-reported and performance-based disability as the dependent variable and age, sex, education, chronic conditions, depression, physical activity and pain characteristics as dependent variables.

Results: Mean (SD) results for SPPB were 8.45 (2.86) and 20.06 (8.21) for WHODAS. Pain intensity, depression, pain frequency, number of chronic conditions and level of physical activity explained 44% of the self-reported disability variance. Pain intensity, age, level of physical activity, years of formal education and chronic conditions explained 37% of the performance variance. Pain intensity alone explained 27% and 18% of the self-reported and performance based disability, respectively.

Conclusion: Findings indicate that primary health care interventions should target pain intensity, depressive symptoms and physical activity as a means to preventing or decreasing both self-reported and performance based disability.

Keywords: Determinants; Pain intensity; Performance-based disability; Self-reported disability.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Depression* / complications
  • Disability Evaluation*
  • Disabled Persons* / psychology
  • Exercise*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain* / complications
  • Primary Health Care
  • Self Report*
  • Severity of Illness Index