Does chronic pain hinder physical activity among older adults with type 2 diabetes?

Figures & data

Table 1. Prevalence of chronic pain by different background variables (N = 1177^a).

	Chronic pain, % (n)	p-value
Whole sample	64.3 (757)
Gender Man Woman	58.3 (376) 71.6 (379)	<0.001***
Age (years) 65–69 70–75	65.3 (419) 63.2 (338)	0.457
Diabetes duration (years) < 5 5–10 > 10	62.4 (166) 64.4 (299) 62.6 (239)	0.803
Education level Lower Higher	64.3 (454) 63.6 (281)	0.802
BMI (kg/m^2) < 25 25.0–29.9 ≥ 30	58.0 (109) 60.7 (281) 70.1 (340)	0.001**
Diabetes medication Only tablets Other	64.0 (563) 63.7 (165)	0.936
Diabetes complication Yes No	69.4 (365) 59.2 (351)	<0.001***
Other chronic disease or condition Yes No	65.1 (736) 37.1 (13)	0.001**
Amount of other chronic diseases or conditions 0 1 2 3 ≥ 4	30.8 (8) 40.5 (30) 45.8 (65) 61.8 (107) 74.6 (259)	<0.001***
Perceived health Poor Good	73.6 (452) 53.7 (297)	<0.001***
Neuropathy Yes No	84.0 (105) 62.0 (652)	<0.001***

Notes: Differences between groups are tested by χ² test. Results are given as the proportion [% (n)] of respondents that had chronic pain in the different groups.

**p < 0.01, ***p < 0.001.

^aRespondents in the whole study sample who answered the question about presence of chronic pain.

Table 2. Distribution of pain frequency (N = 701) and pain intensity (N = 706) among respondents with chronic pain.

		Respondents with chronic pain
		All, % (n)	Physically active, % (n)	Physically inactive, % (n)
Pain frequency
Seldom		45.5 (319)	49.9 (259)	33.0 (60)
Often		54.5 (382)	50.1 (260)	67.0 (122)
Total		100.0 (701)	100.0 (519)	100.0 (182)
χ^2			15.587, p < 0.001
Pain intensity
Mild		36.8 (260)	40.0 (209)	27.7 (51)
Moderate		46.6 (329)	46.8 (244)	46.2 (85)
Severe		16.6 (117)	13.2 (69)	26.1 (48)
Total		100.0 (706)	100.0 (522)	100.0 (184)
χ^2			19.211, p < 0.001

Note: Seldom: pain seldom or sometimes; Often: pain often, daily or all the time, Mild: mild or very mild pain during the past four weeks; Severe: severe or very severe pain during the past four weeks.

Table 3. Relationship between presence of chronic pain and engagement in PA in the whole study sample, and between frequency and intensity of pain and engagement in PA among respondents with chronic pain.

				Women		Men
	OR (95% CI)	P		OR (95% CI)	p	OR (95% CI)	p		OR (95% CI)	p
Bivariate model (N = 1133^a )				Bivariate model (N = 353^b )		Bivariate model (N = 346^b)		Bivariate model (N = 706^b )
Chronic pain  No  Yes	1.000 0.642 (0.474–0.870)	0.004**	Pain frequency - Seldom - Often	1.000 0.309 (0.173–0.553)	<0.001***	1.000 0.680 (0.420–1.099)	0.115	Pain intensity - Mild - Moderate - Severe	1.000 0.700 (0.473–1.038) 0.351 (0.217–0.566)	0.076 <0.001***
Multivariate model (N = 997 ^a)				Multivariate model (N = 315 ^b)		Multivariate model (N = 308 ^b)		Multivariate model (N = 625 ^b)
Chronic pain  No  Yes	1.000 0.851 (0.587–1.234)	0.395	Pain frequency - Seldom - Often	1.000 0.335 (0.160–0.701)	0.004**	1.000 0.972 (0.540–1.747)	0.924	Pain intensity - Mild - Moderate - Severe	1.000 0.870 (0.533–1.420) 0.507 (0.276–0.931)	0.577 0.029*
Gender  Woman  Man	1.000 0.948 (0.666–1.349)	0.767						Gender - Woman - Man	1.000 0.794 (0.515–1.225)	0.298
Age	0.890 (0.844–0.939)	<0.001***	Age	0.894 (0.812–0.986)	0.024*	0.927 (0.845–1.018)	0.112	Age	0.910 (0.853–0.972)	0.005**
Education level  Lower  Higher	1.000 1.387 (0.969–1.986)	0.074	Education level - Lower - Higher	1.000 1.137 (0.593–2.182)	0.699	1.000 1.488 (0.812–2.728)	0.198	Education level - Lower - Higher	1.000 1.456 (0.936–2.267)	0.096
BMI	0.872 (0.843–0.902)	<0.001***	BMI	0.848 (0.797–0.902)	<0.001***	0.872 (0.822–0.926)	<0.001***	BMI	0.862 (0.826–0.899)	<0.001***
Perceived health  Poor  Good	1.000 1.112 (0.750–1.650)	0.597	Perceived health - Poor - Good	1.000 1.021 (0.490–2.127)	0.957	1.000 1.464 (0.739–2.900)	0.275	Perceived health - Poor - Good	1.000 1.307 (0.797–2.144)	0.288
Autonomous motivation	1.644 (1.422–1.901)	<0.001***	Autonomous motivation	1.798 (1.366–2.367)	<0.001***	1.437 (1.136–1.817)	0.003**	Autonomous motivation	1.600 (1.332–1.921)	<0.001***
Energy	1.017 (1.007–1.026)	<0.001***	Energy	1.020 (1.004–1.036)	0.015*	1.015 (0.999–1.032)	0.065	Energy	1.016 (1.005–1.028)	0.004**
Social support	0.887 (0.650–1.209)	0.448	Social support	0.806 (0.517–1.255)	0.339	0.690 (0.435–1.095)	0.116	Social support	0.676 (0.460–0.991)	0.045*
Nagelkerke R^2 = 0.296				Nagelkerke R^2 = 0.385		Nagelkerke R^2 = 0.254		Nagelkerke R^2 = 0.311

Notes: The relationship between the frequency of pain and engagement in PA is presented for women and men separately. Bivariate and multivariate logistic regression analysis.

OR: odds ratio; CI: confidence interval; OR in reference group = 1.000.

*p<0.05, **p < 0.01, ***p < 0.001.

^aRespondents in the whole study sample who answered both the question about presence of chronic pain and the question about engagement in PA.

^bRespondents with chronic pain.

Table 4. Relationship between frequency and intensity of pain and engagement in exercise among respondents who had chronic pain and were physically active.

	OR (95% CI)	p		OR (95% CI)	p
Bivariate model (N = 519)			Bivariate model (N = 522)
Pain frequency  Seldom  Often	1.000 0.848 (0.573–1.255)	0.410	Pain intensity Mild Moderate Severe	1.000 0.954 (0.626–1.454) 1.064 (0.577–1.961)	0.826 0.842
Multivariate model (N = 464)			Multivariate model (N = 465)
Pain frequency  Seldom  Often	1.000 1.075 (0.677–1.707)	0.760	Pain intensity  Mild  Moderate  Severe	1.000 1.103 (0.679–1.792) 1.196 (0.588–2.432)	0.693 0.621
Gender  Woman  Man	1.000 1.576 (1.002–2.477)	0.049*	Gender  Woman  Man	1.000 1.611 (1.027–2.527)	0.038*
Age	0.963 (0.897–1.033)	0.288	Age	0.975 (0.910–1.045)	0.480
Education level  Lower  Higher	1.000 1.231 (0.785–1.931)	0.366	Education level  Lower  Higher	1.000 1.228 (0.785–1.921)	0.369
BMI	1.038 (0.986–1.093)	0.152	BMI	1.043 (0.991–1.098)	0.107
Perceived health  Poor  Good	1.000 1.978 (1.201–3.257)	0.007**	Perceived health  Poor  Good	1.000 1.835 (1.120–3.006)	0.016*
Autonomous motivation	1.597 (1.261–2.021)	<0.001***	Autonomous motivation	1.567 (1.240–1.981)	<0.001***
Energy	1.011 (0.997–1.025)	0.117	Energy	1.012 (0.998–1.026)	0.087
Social support	0.549 (0.359–0.840)	0.006**	Social support	0.577 (0.378–0.881)	0.011*
Nagelkerke R^2 = 0.119			Nagelkerke R^2 = 0.113

Notes: Bivariate and multivariate logistic regression analysis. OR: odds ratio; CI: confidence interval; OR in reference group = 1.000.

*p< 0.05, **p < 0.01, ***p < 0.001