Pain, obesity, and physical function in Mexican American older adults during 20 years of follow-up

Introduction: Pain remains largely undertreated in older adults irrespective of health care setting. Mexican American adults in the United States have a high age-adjusted prevalence of obesity. However, the association of pain and obesity with physical function is understudied in this population. Objective: To examine the association of co-occurring pain and obesity with physical function over 20 years of follow-up in a cohort of older Mexican Americans who scored ≥7 (moderate to high) in the Short Physical Performance Battery (SPPB) test and were nondisabled at baseline. Design: Longitudinal population-based study. Setting: Community-dwelling older adults from Southwestern United States. Participants: Mexican American adults age 65 years and older. Interventions: Not Applicable. Main Outcome Measures: Physical function was assessed with the SPPB test (standing balance, timed 8-ft walk, and five repeated timed chair stands). Participants at baseline were divided into four groups: no pain–no obesity (n = 869), obesity only (n = 282), pain only (n = 216), and pain-obesity (n = 159). Generalized Estimating Equation models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) of lower performance in physical function over 20 years as a function of pain-obesity grouping. Results: Participants with pain only (OR = 1.61, 95% CI = 1.34–1.95) and with co-occurring pain and obesity (OR = 2.32, 95% CI = 1.83–2.95) had significantly greater odds of physical function impairment over those with no pain–no obesity or obesity only, after controlling for all covariates. Conclusion: Older Mexican American adults were at high risk for physical function impairment over time if they had pain or co-occurring pain and obesity. Early assessment and proper pain management as well as maintaining a healthy weight may reduce declines in physical function in older Mexican American adults.