Pain-related restriction of going out and instrumental activities of daily living limitation among community-dwelling older adults in Japan: a cross-sectional study

Objective This study investigated the association between low back or leg pain-related restriction of going out and instrumental activities of daily living (IADL) limitation among community-dwelling older adults in Japan. Methods This cross-sectional study analyzed data from the Public Survey of Long-Term Care Prevention and Needs in Spheres of Daily Life conducted 2018-2020. A total of 28,118 community-dwelling adults aged 65 years or older without certified care needs were included (response rate: 83.7%). Pain was assessed by self-report as low back or leg pain-related restriction of going out. IADL limitation was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Odds ratios (ORs) and 95% confidence intervals (CIs) for IADL limitation were estimated using logistic regression models adjusted for potential confounders. Results Participants with low back or leg pain-related restriction of going out had higher odds of IADL limitation compared with those with no reported restriction of going out (adjusted OR 3.83; 95% CI 3.44-4.27). Subgroup analyses showed this association was observed in both men and women and in adults aged 65-74 years and those aged 75 years or older. Conclusions Low back or leg pain-related restriction of going out was associated with greater likelihood of IADL limitation among community-dwelling older adults in Japan. These findings suggest that pain-related restriction of going out may be an important marker of IADL limitation. Future longitudinal studies are needed to clarify temporal relationships between pain-related restriction of going out and IADL limitation.