title: Two colliding epidemics - obesity is independently associated with chronic pain interfering with activities of daily living in adults 18 years and over; a cross-sectional, population-based study.
abstract: Chronic pain interfering with activities of daily living is highly prevalent in the community. More than 600 million people worldwide are obese. The aim of this paper is to assess if such chronic pain is associated independently with obesity across the adult population, having controlled for other key factors.
  
  
  
  The South Australian Health Omnibus is an annual, population-based, cross-sectional study. Data on 2616 participants were analysed for episodes of daily pain for three of the preceding six months. Obesity was derived from self-reported height and weight. Multivariable logistic regression analysed the associations between chronic pain interfering with activities of daily living, body mass index (BMI) and key socio-demographic factors.
  
  
  
  Chronic pain interfering with activities of daily living peaks in people ≥75 years of age while obesity peaks in the 45-54 age group. Pain and obesity together peak in the 55-74 year age group. In the adjusted multinominal logistic regression model, compared to those with no pain, there was a strong association between obesity and pain that interfered moderately or extremely with day-to-day activities (OR 2.25; 95 % CI 1.57-3.23; p < 0.001) having controlled for respondents' age, gender, rurality, country of birth and highest educational attainment. People over 65 years of age and those with lower educational levels were more likely to experience such chronic pain related to obesity.
  
  
  
  This study demonstrates a strong association between chronic pain and obesity/morbid obesity in the South Australian population. Prospective, longitudinal data are needed to understand the dynamic interaction between these two prevalent conditions.
authors.affiliation: Southern Adelaide Palliative Services, Repatriation General Hospital, Daw Park, Adelaide, Australia. Sharon.Allen2@sa.gov.au.
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Allen
authors.affiliation: Population Research and Outcomes Studies Unit, Discipline of Medicine, Health Sciences Faculty, Adelaide University, Adelaide, Australia.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Dal Grande
authors.affiliation: Discipline, Palliative and Supportive Services, Flinders University, Bedford Park, Adelaide, Australia.|Division of Medical Oncology, Department of Medicine, Duke University Medical Centre, Durham, North Carolina, USA.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.affiliation: Southern Adelaide Palliative Services, Repatriation General Hospital, Daw Park, Adelaide, Australia.|Discipline, Palliative and Supportive Services, Flinders University, Bedford Park, Adelaide, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D059350:Chronic Pain / Q000150:complications* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D058872:Epidemics; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D013021:South Australia; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Impaired activities of daily living; Obesity; Pain; Period prevalence; Population survey