{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:48:51Z","timestamp":1791294531429,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T00:00:00Z","timestamp":1399939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["P01AG004390"],"award-info":[{"award-number":["P01AG004390"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["R01AG041525-01"],"award-info":[{"award-number":["R01AG041525-01"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004319","name":"Pfizer Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["1K24HD070966-01"],"award-info":[{"award-number":["1K24HD070966-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the effects of chronic pain on the development of disability and decline in physical performance over time in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Longitudinal cohort study with 18\u00a0months of follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Urban and suburban communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Community\u2010dwelling older adults aged 65 and older (N\u00a0=\u00a0634).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Chronic pain assessment consisted of musculoskeletal pain locations and pain severity and pain interference according to the subscales of the Brief Pain Inventory. Disability was self\u2010reported as any difficulty in mobility and basic and instrumental activities of daily living (\n                      <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>\n                      s,\n                      <jats:styled-content style=\"fixed-case\">IADL<\/jats:styled-content>\n                      s). Mobility performance was measured using the Short Physical Performance Battery (\n                      <jats:styled-content style=\"fixed-case\">SPPB<\/jats:styled-content>\n                      ). Relationships between baseline pain and incident disability in 18\u00a0months were determined using risk ratios (\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      s) from multivariable Poisson regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Almost 65% of participants reported chronic musculoskeletal pain at baseline. New onset of mobility difficulty at 18\u00a0months was strongly associated with baseline pain distribution: 7% (no sites), 18% (1 site), 24% (multisite), and 39% (widespread pain,\n                      <jats:italic>P<\/jats:italic>\n                      \u2010value for trend &lt;\u00a0.001). Similar graded effects were found for other disability measures. Elderly adults with multisite or widespread pain had at a risk of onset of mobility difficulty at least three times as great as that of their peers without pain after adjusting for disability risk factors (multisite pain: risk ratio (\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      )\u00a0=\u00a02.95, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ) 1.58\u20135.50; widespread pain:\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      \u00a0=\u00a03.57, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.71\u20137.48). Widespread pain contributed to decline in mobility performance (1\u2010point decline in\n                      <jats:styled-content style=\"fixed-case\">SPPB<\/jats:styled-content>\n                      ,\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      \u00a0=\u00a01.47, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.08\u20132.01). Similar associations were found for baseline pain interference predicting subsequent mobility decline and\n                      <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">IADL<\/jats:styled-content>\n                      disability. Weaker and less\u2010consistent associations were observed with pain severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older community\u2010dwelling adults living with chronic pain in multiple musculoskeletal locations have a substantially greater risk for developing disability over time and for clinically meaningful decline in mobility performance than those without pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.12848","type":"journal-article","created":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T11:12:13Z","timestamp":1399979533000},"page":"1007-1016","source":"Crossref","is-referenced-by-count":183,"title":["Pain Characteristics Associated with the Onset of Disability in Older Adults: The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study"],"prefix":"10.1111","volume":"62","author":[{"given":"Laura H. 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