Exposure to Ageism Among United States Older Adults With and Without Chronic Pain: Prevalence and Associations With Pain‐Related Treatment Factors
Emily C. Harris, Lisa R. LaRowe, Gab Pasia, Meera Srinivasan, Andrea Mayfield, John Dombrowski, Francis J. Keefe, Alexander K. Smith, Bruce A. Cooper, Lee‐Jen Wei, Christine Miaskowski, Christine S. RitchieABSTRACT
Background
Recent work suggests age discrimination can increase the risk for chronic pain among older adults. This study's aim was to examine the prevalence of exposure to ageism and its impact on chronic pain.
Methods
A nationally representative sample of 2029 adults ≥ 65 years old was recruited from the AmeriSpeak Panel. Participants were asked about five experiences of ageism. Older adults with chronic pain (pain on most/nearly every day in the past 3 months) reported pain self‐efficacy, barriers to treatment, and use of specific therapies. Exposure to ageism was examined as a function of chronic pain status. Adjusted logistic and linear regressions were used to test associations between exposure to ageism and pain self‐efficacy, likelihood of endorsing barriers to care, and use of pain treatments.
Results
More than half of older adults reported at least one prior exposure to ageism. Older adults with (vs. without) chronic pain were more likely to report exposure to ageism (OR: 1.62; 95% CI: 1.28–2.06). Among older adults with chronic pain, exposure to ageism was associated with lower pain self‐efficacy and more perceived barriers to care (all p < 0.05). Finally, more exposure to ageism was associated with lower odds of using tai chi (OR: 0.89; 0.79–0.99), massage (OR: 0.93; 95% CI: 0.87–0.99), and cannabis (OR: 0.87; 95% CI: 0.77–0.99), though these associations did not remain statistically significant after correction for multiple testing.
Conclusions
Participants with chronic pain were more likely than those without to report exposure to ageism. Among older adults with chronic pain, greater exposure to ageism was associated with less confidence in one's ability to manage pain, more barriers to treatment, and lower odds of using certain therapies. These results suggest that exposure to ageism may represent a barrier to successful chronic pain management in older adults.