Lifestyle factors, mental health, and incident and persistent intrusive pain among ageing adults in South Africa

The purpose of this study was to evaluate longitudinal associations with incident and persistent intrusive pain among rural South Africans. Longitudinal data from two consecutive waves in 2014/2015 and 2018/2019 in Agincourt, South Africa, were analysed. Pain was assessed with the Brief Pain Inventory. In all, 683 adults of 3,628 participants without intrusive pain in Wave 1 (19.1%) had incident intrusive pain in Wave 2, 94 adults of 254 participants who had intrusive pain in Wave 1 (38.3%) had intrusive pain at both Wave 1 and 2 (persistent intrusive pain). Furthermore, 358 (7.2%) participants had intrusive pain at baseline. In the fully adjusted model for people without intrusive pain at baseline, the study found that obesity (AOR: 1.31, 95% CI: 1.05-1.63), depressive symptoms (AOR: 1.67, 95% CI: 1.34-2.08), PTSD (AOR: 1.71, 95% CI: 1.19-2.45), and poor sleep quality (AOR: 1.30, 95% CI: 1.04-1.62) were positively associated with incident intrusive pain. Older age was positively, and male sex and daily alcohol use were negatively associated with incident intrusive pain. Furthermore, in the final adjusted logistic regression model, this study found that older age was positively, and underweight, overweight, and high sedentary behavior were negatively associated with persistent intrusive pain. Several modifiable risk factors for incident and/or persistent intrusive pain were identified.