Pain Lowers Subjective Survival Probabilities among Middle-aged and Older Adults

Gillian Fennell, Margarita Osuna, Jennifer Ailshire, Anna Zajacova
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Abstract

Objective Pain is a leading cause of disability and a limiting factor in individuals’ assessments of their own subjective health, however its association with subjective longevity has yet to be explored. Subjective survival probabilities (SSPs), or one’s own perceived chances of living to a given age, can influence individuals’ behavior as they plan for their futures. This study assesses whether pain correlates to lower SSPs. Methods We use a repeated cross-section of the 2000-2018 waves of the Health and Retirement Study, a longitudinal and nationally representative survey of Americans aged 51 and older (N=31,773). Results Fractional logit regressions indicate that, across all age groups, respondents with severe and/or interfering pain reported significantly lower SSPs than those with no pain (Marginal Effect (ME) = -0.03 to -0.06, p < .05). Controlling for all covariates, mild or moderate non-interfering pain was only associated with a significant reduction in SSPs among the youngest group reporting their chances of living to age 75 (ME = -0.02, p < .001). Descriptively and in the model results, respondents with mild or moderate non-interfering pain appeared to more closely resemble pain-free respondents than those with severe or interfering pain. Discussion These findings highlight the importance of pain on SSPs, and contribute to the growing evidence that pain interference is uniquely important in predicting meaningful health outcomes.
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疼痛会降低中老年人的主观生存概率
客观疼痛是导致残疾的主要原因,也是个人评估自身主观健康状况的一个限制因素,但它与主观寿命的关系还有待探讨。主观生存概率(SSPs),即一个人自己认为能活到特定年龄的机会,会影响个人规划未来的行为。本研究评估了疼痛是否与较低的主观生存概率相关。方法 我们使用了 2000-2018 年健康与退休研究(Health and Retirement Study)的重复横截面数据,这是一项针对 51 岁及以上美国人的具有全国代表性的纵向调查(N=31,773)。结果 分数对数回归表明,在所有年龄组中,有严重和/或干扰性疼痛的受访者报告的 SSP 明显低于没有疼痛的受访者(边际效应 (ME) = -0.03 至 -0.06,p &p;lt;.05)。在控制所有协变量的情况下,轻度或中度非干扰性疼痛仅与报告有机会活到 75 岁的最年轻群体的 SSPs 明显降低有关(边际效应(ME)= -0.02,p &;lt;.001)。从描述性和模型结果来看,轻度或中度非干扰性疼痛的受访者似乎比重度或干扰性疼痛的受访者更接近于无痛受访者。讨论 这些发现凸显了疼痛对 SSP 的重要性,并为越来越多的证据表明疼痛干扰在预测有意义的健康结果方面具有独特的重要性做出了贡献。
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