Chronic pain and kinesiophobia among older adults. Prevalence, characteristics and impact on physical activity.

Research output: ThesisDoctoral Thesis (compilation)


Background: Chronic pain is common in older adults, yet little is known of its development in old age. Although fear-avoidance beliefs in chronic pain have been explored in younger adults, the relationship between chronic pain, kinesiophobia and physical activity levels has not been investigated in older adults.

Objectives: The overall aim was to explore prevalence, development and related factors of chronic pain and kinesiophobia in older adults with a focus on psychosocial and pain related factors and their impact on physical activity among older adults.

Methods: The study had a longitudinal design and data were obtained through posted surveys and collected at baseline and after 12 and 24 months during 2011–2013. Participants (N=2000) were selected through simple randomization of the Swedish register of inhabitants using the whole Swedish population aged 65+, as sampling frame. A total of 1141 older adults were included at baseline (aged 65–103 years). Prevalence, incidence rate and cumulative incidence of chronic pain over 2 years in different age strata were estimated. To estimate associations for demographic, psychosocial and pain-related variables as functions of chronic pain (persistence and onset), kinesiophobia and physical activity linear/logistic regression analysis were performed.

Results: In paper I, chronic pain was reported by 38.5% of the participants, more common among females and those over 85 years. The incidence was estimated at 5.4%. Being female, having lower BMI, high intensity/severity, long duration and multiple locations of pain were able to predict persistence of chronic pain among older women. Paper II showed that TSK-11 had acceptable construct validity, factor structure and test-retest reliability. In Papers III–IV generally low levels of kinesiophobia were found among those with chronic pain, except among frailer and older adults living in care homes. Despite this, it was found that kinesiophobia was independently associated with levels of physical activity and significantly lower levels of physical activity among those with chronic pain.

Conclusions: Even though chronic pain was often highly prevalent and persistent, both onset and recovery occurred over time. The findings highlight the importance of early pain management in prevention of future pain among older adults. It must also be considered that older adults with chronic pain are at higher risk of functional decline and additional chronic diseases, due to significantly lower levels of physical activity compared to older without chronic pain. Kinesiophobia among older adults can be captured by the TSK-11 and plays an important role in predicting future physical activity levels and is hence important to consider. Potential interventions against kinesiophobia among older adults should aim to decrease pain intensity and strengthen health beliefs.


Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Physiotherapy
  • Gerontology, specializing in Medical and Health Sciences
  • Public Health, Global Health, Social Medicine and Epidemiology
Original languageEnglish
Awarding Institution
Supervisors/Assistant supervisor
Award date2016 Sep 15
Place of PublicationLund
  • Lund University, Faculty of Medicine
Print ISBNs978-91-7619-304-4
Publication statusPublished - 2016
Publication categoryResearch

Bibliographic note

Defence details Date: 2016-09-15 Time: 09:00 Place: Aulan, CRC, ingång 72, Jan Waldenströms gata 35, Skånes Universitetssjukhus i Malmö. External reviewer(s) Name: Bergman, Stefan Title: professor Affiliation: University of Gothenburg --- ISSN: 1652-8220 Lund University, Faculty of Medicine Doctoral Dissertation Series 2016:78

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