Life Expectancy With and Without Pain in the U.S. Elderly Population

J Gerontol A Biol Sci Med Sci. 2016 Sep;71(9):1171-6. doi: 10.1093/gerona/glw028. Epub 2016 Mar 17.


Background: This study contributes to dialogue on quality versus quantity of life by examining years older persons can expect to live in various states of pain.

Methods: Data from seven waves of the Health and Retirement Study; N = 26,896; age 55+. Estimations using the Interpolative Markov Chain approach apply probability transitions to multistate life table functions. Two estimates are interpreted: (i) population-based, which provide population averages aggregated across baseline states and (ii) status-based, which provide independent estimates by baseline state. Age- and sex-specific years with no pain, milder nonlimiting, and severe or limiting pain are reported as is percent of life in states of pain.

Results: Females have higher life expectancy than males but similar expectations of pain-free life. Total life expectancy varies only slightly by baseline pain states but pain-free life expectancy varies greatly. For example, an 85-year-old female pain-free at baseline expects 7.04 more years, 5.28 being pain-free. An 85-year-old female with severe pain at baseline expects 6.42 years with only 2.66 pain-free. Percent of life with pain decreases by age for those pain-free at baseline and increases for those with pain at baseline.

Conclusion: Pain is moderately associated with quantity of or total life but substantially and importantly associated with quality of or pain-free life.

Keywords: Aging; Demography; Health and Retirement Survey; Interpolative Markov Chains; Longevity; Multistate life tables; Quality of life.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Aging*
  • Disabled Persons* / statistics & numerical data
  • Female
  • Health Status Indicators
  • Humans
  • Incidence
  • Life Expectancy*
  • Life Tables
  • Male
  • Middle Aged
  • Pain / epidemiology*
  • Quality of Life*
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology