Xinru Han,1,* Yiwei Qiao,1,* Jialong Tan,1 Zhi Luo,2 Stephen Nicholas,3,4 Elizabeth Maitland,5 Lu Han,1 Zhihao Xu,1 Jian Wang1,6 

1Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, People’s Republic of China; 2Economics and Management School, Wuhan University, Wuhan, People’s Republic of China; 3Health Services Research and Workforce Innovation Centre, Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia; 4Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, NSW, Australia; 5School of Management, University of Liverpool, Liverpool, UK; 6Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Wuhan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jian Wang, Dong Fureng Institute of Economic and Social Development, Wuhan University, No. 299, Bayi Road, Wuchang District, Wuhan, Hubei, 430072, People’s Republic of China, Email wangjian993@whu.edu.cn

Background: As societies worldwide experience rapid aging, social isolation and loneliness are as prevalent and impactful on health outcomes of older adults as other well-recognized risk factors. This study investigates the association of social isolation and loneliness on the prevalence of chronic pain among Chinese older adults.
Methods: Participants from waves of the Chinese Health and Retirement Longitudinal Study (CHARLS) with no chronic pain in baseline 2011, and their conditions of chronic pain in wave 2018, were analyzed. The exposure factors were social isolation and loneliness. Social isolation was assessed by a comprehensive multi-factor measure, while loneliness and the outcome variable, chronic pain, were self-reported. The association of the exposure factors on the prevalence of chronic pain was conducted by logistic regression.
Results: Adults 60 years old and over who did not suffer from chronic pain at baseline in 2011 were enrolled, of whom 1669 participants (53.68%) developed chronic pain, and 1440 did not develop chronic pain, over a span of seven years. The results showed that social isolation (OR: 1.21, 95% CI: 1.01– 1.45) and loneliness (OR: 1.61, 95% CI: 1.36– 1.92) were associated with an elevated risk of chronic pain over seven years. It showed no statistically significant interaction associations between social isolation and feelings of loneliness.
Conclusion: Older adults with social isolation or loneliness tended to experience chronic pain, emphasizing the importance of incorporating social support and community engagement into chronic pain treatment strategies.

Keywords: social isolation, loneliness, chronic pain, cohort study