The impact of older age on the relation between chronic musculoskeletal pain and health-related quality of life: The Maastricht Study

• Mental health impact of chronic musculoskeletal pain peaked in adults aged 40–44 • Older age did not worsen impact of chronic musculoskeletal pain on physical health • Pain care should adapt to individual needs in both middle-aged and older adults Objective To test the hypothesis that older age negatively impacts the association between chronic musculoskeletal pain (MSP) and health-related quality of life (HRQoL). Methods Cross-sectional data of 8618 participants aged 40-75 years from the population-based Maastricht Study cohort was used. Chronic MSP presence was self-reported. Pain intensity was measured on a 0-10 scale (10: unbearable pain). Age (seven groups) and chronic MSP (intensity) were regressed in multivariable analyses on (components of) HRQoL: The mental (MCS) and physical component score (PCS) of the 36-item Short Form Survey (SF-36), the EuroQol-VAS measuring overall HRQoL, and (un)paid work days lost in the past six months. Interactions between age groups and chronic MSP were examined. Results Chronic MSP was reported by 2513/8618 (29%) participants and was associated with worse PCS (β=-7.4, 95%CI:-7.8 to -7.1), MCS (β=-1.8, 95%CI:-2.2 to -1.5), EuroQol-VAS (β=-7.9, 95%CI:-8.9 to -7.0), and a higher likelihood of unproductive days (OR=2.1, 95%CI:1.9–2.4). An interaction between age group and MSP was only observed for mental health: The negative impact of MSP on mental health was lower in individuals aged 70–75 years (β=-0.4, 95%CI:-1.3 to 0.6) compared to those aged 40–44 years (β=-3.1, 95%CI:-5.0 to -1.2) ( p interaction <0.05). Age >60 years was associated with fewer unproductive days, independent of MSP (OR range age groups: 0.6 to 0.3; all p <0.01). Conclusion Although chronic MSP negatively affects physical and mental health as well as work productivity, our findings suggest an unexpected resilience in mental HRQoL among older adults.