Are We Adding Pain-Free Years to Life? A Test of Compression Versus Expansion of Morbidity

TitleAre We Adding Pain-Free Years to Life? A Test of Compression Versus Expansion of Morbidity
Publication TypeJournal Article
Year of Publication2024
AuthorsZimmer, Z, Sun, F, Duynisveld, A
JournalThe Journals of Gerontology: Series A
ISSN Number1758-535X
KeywordsChronic pain, Health expectancy, Longevity, Longitudinal analysis, Multistate life tables

There has been debate regarding whether increases in longevity result in longer and healthier lives or more disease and suffering. To address the issue, this paper uses health expectancy methods and tests an expansion versus compression of morbidity with respect to pain.

Data are from 1993 to 2018 Health and Retirement Study. Pain is categorized as no pain, non-limiting and limiting pain. Multistate life tables examine 77,996 wave-to-wave transitions across pain states or death using the Stochastic Population Analysis for Complex Events program. Results are presented as expected absolute and relative years of life for 70-, 80- and 90-year-old males and females. Confidence intervals assess significance of differences over time. Population- and status-based results are presented.

For those 70 and 80 years old, relative and absolute life with non-limiting and limiting pain increased substantially for males and females, and despite variability on a wave-to-wave basis, results generally confirm an expanding pain morbidity trend. Results do not vary by baseline status, indicating those already in pain are just as likely to experience expansion of morbidity as those pain-free at baseline. Results are different for 90-year-olds who have not experienced expanding pain morbidity and do not show an increase in life expectancy.

Findings are consistent with extant literature indicating increasing pain prevalence among older Americans and portend a need for attention on pain-coping resources, therapies, and prevention strategies.

Citation Key14037