Life expectancy with and without pain in the U.S. elderly population

Abstract

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 painfree life.