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J Gerontol A Biol Sci Med Sci. 2016 Sep;71(9):1171-6. doi: 10.1093/gerona/glw028. Epub 2016 Mar 17.

Life Expectancy With and Without Pain in the U.S. Elderly Population.

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Department of Social and Behavioral Sciences, University of California, San Francisco.
Department of Social and Behavioral Sciences, University of California, San Francisco.



This study contributes to dialogue on quality versus quantity of life by examining years older persons can expect to live in various states of pain.


Data from seven waves of the Health and Retirement Study; N = 26,896; age 55+. Estimations using the Interpolative Markov Chain approach apply probability transitions to multistate life table functions. Two estimates are interpreted: (i) population-based, which provide population averages aggregated across baseline states and (ii) status-based, which provide independent estimates by baseline state. Age- and sex-specific years with no pain, milder nonlimiting, and severe or limiting pain are reported as is percent of life in states of pain.


Females have higher life expectancy than males but similar expectations of pain-free life. Total life expectancy varies only slightly by baseline pain states but pain-free life expectancy varies greatly. For example, an 85-year-old female pain-free at baseline expects 7.04 more years, 5.28 being pain-free. An 85-year-old female with severe pain at baseline expects 6.42 years with only 2.66 pain-free. Percent of life with pain decreases by age for those pain-free at baseline and increases for those with pain at baseline.


Pain is moderately associated with quantity of or total life but substantially and importantly associated with quality of or pain-free life.


Aging; Demography; Health and Retirement Survey; Interpolative Markov Chains; Longevity; Multistate life tables; Quality of life

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