title: The mediating effect of chronic pain on the relationship between obesity and physical function and disability in older adults.
abstract: OBJECTIVE
  To determine the extent to which bodily pain mediates the effect of obesity on disability and physical function.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Population-based sample of residents in the greater Boston area.
  
  
  METHODS
  Community-dwelling adults aged 70 and older (N=736).
  
  
  METHODS
  Body mass index (BMI), obtained from measured height and weight, was categorized as normal weight (19.0-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese (≥30.0 kg/m2). Main outcome measures were the Physical Component Summary of the Medical Outcomes Study 12-item Short-Form Survey (PCS), activity of daily living (ADL) disability, and Short Physical Performance Battery (SPPB) score. Chronic pain was assessed according to the number of weight-bearing joint sites that had pain (hips, knees, feet and pain all over).
  
  
  RESULTS
  Older obese adults had greater ADL disability and lower SPPB and PCS scores than their nonobese counterparts, although in sex-stratified adjusted analyses, obesity was adversely associated with outcomes only in women. Obesity was associated with greater number of pain sites; and more pain sites were associated with greater odds of disability. Mediation analysis suggests that pain is a significant mediator (22-44%) of the adverse effect of obesity on disability and physical function in women.
  
  
  CONCLUSIONS
  Bodily pain may be an important treatable mediator of the adverse effect of obesity on disability and physical function in women.
authors: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors: Angela
authors: A
authors: Fowler-Brown
authors: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors: Christina C
authors: CC
authors: Wee
authors: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.|Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors: Edward
authors: E
authors: Marcantonio
authors: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors: Long
authors: L
authors: Ngo
authors: Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts, Boston, Massachusetts.
authors: Suzanne
authors: S
authors: Leveille
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001900:Boston / Q000453:epidemiology; D059350:Chronic Pain / Q000150:complications* / Q000503:physiopathology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D010147:Pain Measurement; D012307:Risk Factors; D012737:Sex Factors
keywords: disability; obesity; pain; physical function