Prospective associations of chronic and intrusive pain with sarcopenia and physical disability amongst older Australian men: The Concord Health and Ageing in Men Project

Background: Associations of chronic and intrusive pain with sarcopenia and disability in older men are unclear. Methods: 1452 community-dwelling men aged ≥70 years self-reported chronic pain (pain every day for ≥3 months) and intrusive pain (pain interfering with normal activities in the last 4 weeks) at baseline and five years later, and were classified as having no, prevalent (baseline only), incident (follow-up only) or persistent (both baseline and follow-up) pain. Appendicular lean mass (ALM), hand grip strength and gait speed were assessed. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Diagnosis and Outcomes Consortium (SDOC) definitions. Activity of daily living (ADL) and instrumental activity of daily living (IADL) impairment were assessed by questionnaires. Results: Approximately 11% of men reported both chronic and intrusive pain. Gait speed, but not ALM or hand grip strength, significantly mediated the relationship of chronic pain and intrusive pain with ADL and IADL disability by 12–57%. Over five years, incident (odds ratio: 1.84; 95% CI: 1.10–3.10) and persistent (3.02; 1.55–5.88) intrusive pain, and persistent chronic pain (2.29; 1.30–4.04), were associated with increased likelihood of incident sarcopenia (SDOC). Incident and persistent intrusive pain were associated with incident ADL (1.91; 1.04–3.52 and 3.78; 1.90–7.51, respectively) and IADL (2.98; 1.81–4.90 and 4.63; 2.22–9.65, respectively) impairment. Conclusions: Older men with incident and persistent intrusive pain have increased risk for incident sarcopenia and disability over five years. The association of pain with disability appears to be mediated by gait speed.