State and Trait Anxiety Associations with Reported and Experimental Pain in Community Dwelling Older Adults

Pain and anxiety are both commonly reported in older community-dwelling adults and exist reciprocally to impact quality of life. Most previous studies have focused on reported pain, rather than experimental pain, to examine relationships with anxiety. In this study, we investigated the relationship between anxiety and pain during a 7-week longitudinal study of community-dwelling older adults without chronic pain (n=46, 27 female, 73.8±6.4 years old). State and trait anxiety were assessed by self-report using the State-Trait Anxiety Inventory-Short Form. Participants reported pain using the Brief Pain Inventory (BPI-Short Form). Participants also reported current pain intensity and unpleasantness on a numeric pain scale (NPS, 0-20). A subset of participants (n=26) also completed an experimental pain protocol, where we collected pain intensity and unpleasantness ratings during a brief administration of heat pain at three stimuli levels: warmth (34°C), mild pain (39°), and moderate pain (44° C). There was no significant relationship between state or trait anxiety and reported pain on either the BPI-SF or NPS. Trait anxiety was associated with pain interference on the BPI-SF (general activity: p=.015; mood: p=.024; walking ability: p=.003; and enjoyment of life: p=.009). State anxiety was associated with pain interference in general activity (p=.018) and enjoyment of life (p=.006). There was no significant relationship between state or trait anxiety and experimental pain intensity or unpleasantness ratings. While most studies of pain and anxiety report an effect of anxiety on pain reporting, we only found a relationship between anxiety and pain interference for older adults. Our work suggests that measuring pain interference, rather than pain ratings, could be a better way to capture impact of pain on quality of life for older adults. Additionally, targeted interventions that address pain-related anxiety may lessen the impact of pain on the lives of older adults. Grant support from 1R01AG059861-01 (Monroe) NIH/NIA.