Skip to main content

Patterns of pain and mobility limitation in older people: cross-sectional findings from a population survey of 18,497 adults aged 50 years and over


Mobility limitation is the most common disability in the general population, and pain is a frequent symptom at older ages. We have investigated the association of different patterns of pain and mobility limitation in a large sample of older adults. A cross-sectional postal survey of all adults aged 50 years and over registered with eight general practices in North Staffordshire, UK, resulted in 18,497 respondents (adjusted response=70.8%). Information on demographics, recent pain and the self-reported level of mobility limitation was collected. Associations between pain and mobility limitation were assessed using a partial proportional odds model, taking into account age, gender and socio-economic status. Limitation in walking 100 yards was reported by 29% of respondents. Limitation increased sharply with age, and was higher in the female and lower socio-economic groups. Persons reporting pain were significantly more likely to report limitation. The relationship between mobility limitation and pain was stronger in the youngest age group, but proportionally more people in the oldest age groups have mobility limitation associated with pain. Lower limb and multiple pains present a potential target for the prevention of mobility limitation up to the oldest age groups.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2



Confidence interval


Mental component summary


North Staffordshire Osteoarthritis Project


Odds ratio


Physical component summary


Physical functioning scale


Partial proportional odds model


Standard deviation


Socio-economic status


Short Form 12


Short Form 36


  1. 1.

    Martin, J., Meltzer, H., & Elliot, D. (1988). OPCS surveys of disability in Great Britain. Report 1. The prevalence of disability among adults. London: HMSO.

    Google Scholar 

  2. 2.

    Odding, E., Valkenburg, H. A., Stam, H. J., & Hofman, A. (2000). Assessing joint pain complaints and locomotor disability in the Rotterdam study: Effect of population selection and assessment mode. Archives of Physical Medicine and Rehabilitation, 81, 189–193.

    PubMed  CAS  Google Scholar 

  3. 3.

    Peat, G., Thomas, E., Wilkie, R., & Croft, P. (2006). Multiple joint pain and lower extremity disability in middle and old age. Disability and Rehabilitation, 28, 1543–1549.

    PubMed  Article  Google Scholar 

  4. 4.

    Ling, S. M., Fried, L. P., Garrett, E. S., Fan, M. Y., Rantanen, T., & Bathon, J. M. (2003). Knee osteoarthritis compromises early mobility function: The Women’s Health and Aging Study II. Journal of Rheumatology, 30, 114–120.

    PubMed  Google Scholar 

  5. 5.

    Ling, S. M., Xue, Q. L., Simonsick, E. M., Tian, J., Bandeen-Roche, K., Fried, L. P., & Bathon, J. M. (2006). Transitions to mobility difficulty associated with lower extremity osteoarthritis in high functioning older women: Longitudinal data from the Women’s Health and Aging Study II. Arthritis and Rheumatism, 55, 256–263.

    PubMed  Article  Google Scholar 

  6. 6.

    Song, J., Chang, R. W., & Dunlop, D. D. (2006). Population impact of arthritis on disability in older adults. Arthritis and Rheumatism, 55, 248–255.

    PubMed  Article  Google Scholar 

  7. 7.

    Adamson, J., Hunt, K., & Ebrahim, S. (2003). Socioeconomic position, occupational exposures, and gender: The relation with locomotor disability in early old age. Journal of Epidemiology and Community Health, 57, 453–455.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Melzer, D., Gardener, E., & Guralnik, J. M. (2005). Mobility disability in the middle-aged: Cross-sectional associations in the English Longitudinal Study of Ageing. Age and Ageing, 34, 594–602.

    PubMed  Article  Google Scholar 

  9. 9.

    Leveille, S. G., Fried, L., & Guralnik, J. M. (2002). Disabling symptoms: What do older women report? Journal of General Internal Medicine, 17, 766–773.

    PubMed  Article  Google Scholar 

  10. 10.

    Croft, P., Jordan, K., & Jinks, C. (2005). “Pain elsewhere” and the impact of knee pain in older people. Arthritis and Rheumatism, 52, 2350–2354.

    PubMed  Article  Google Scholar 

  11. 11.

    Thomas, E., Peat, G., Harris, L., Wilkie, R., & Croft, P. R. (2004). The prevalence of pain and pain interference in a general population of older adults: Cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain, 110, 361–368.

    PubMed  Article  Google Scholar 

  12. 12.

    Scudds, R. J., & Østbye, T. (2001). Pain and pain-related interference with function in older Canadians: The Canadian Study of Health and Aging. Disability and Rehabilitation, 23, 654–664.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Odding, E., Valkenburg, H. A., Stam, H. J., & Hofman, A. (2001). Determinants of locomotor disability in people aged 55 years and over: The Rotterdam Study. European Journal of Epidemiology, 17, 1033–1041.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Thomas, E., Mottram, S., Peat, G., Wilkie, R., & Croft, P. (2007). The effect of age on the onset of pain interference in a general population of older adults: Prospective findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain, 129, 21–27.

    PubMed  Article  Google Scholar 

  15. 15.

    Ahacic, K., Parker, M. G., & Thorslund, M. (2000). Mobility limitations in the Swedish population from 1968 to 1992: Age, gender and social class differences. Aging (Milano), 12, 190–198.

    CAS  Google Scholar 

  16. 16.

    Fillingim, R. B. (2000). Sex, gender, and pain: Women and men really are different. Current Reviews in Pain, 4, 24–30.

    CAS  Google Scholar 

  17. 17.

    Eachus, J., Chan, P., Pearson, N., Propper, C., & Davey Smith, G. (1999). An additional dimension to health inequalities: Disease severity and socioeconomic position. Journal of Epidemiology Community and Health, 53, 603–611.

    CAS  Google Scholar 

  18. 18.

    Grundy, E., & Glaser, K. (2000). Socio-demographic differences in the onset and progression of disability in early old age: A longitudinal study. Age and Ageing, 29, 149–157.

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Grundy, E., & Holt, G. (2001). The socioeconomic status of older adults: How should we measure it in studies of health inequalities? Journal of Epidemiology and Community Health, 55, 895–904.

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Ebrahim, S., Papacosta, O., Wannamethee, G., & Adamson, J. (2004). Social inequalities and disability in older men: Prospective findings from the British Regional Heart Study. Social Science & Medicine, 59, 2109–2120.

    Article  Google Scholar 

  21. 21.

    Dalstra, J. A. A., Kunst, A. E., Borrell, C., Breeze, E., Cambois, E., Costa, G., Geurts, J. J., Lahelma, E., Van Oyen, H., Rasmussen, N. K., Regidor, E., Spadea, T., & Mackenbach, J. P. (2005). Socioeconomic differences in the prevalence of common chronic diseases: An overview of eight European countries. International Journal of Epidemiology, 34, 316–326.

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Matthews, R. J., Smith, L. K., Hancock, R. M., Jagger, C., & Spiers, N. A. (2005). Socioeconomic factors associated with the onset of disability in older age: A longitudinal study of people aged 75 years and over. Social Science & Medicine, 61, 1567–1575.

    Article  Google Scholar 

  23. 23.

    Shumway-Cook, A., Ciol, M. A., Yorkston, K. M., Hoffman, J. M., & Chan, L. (2005). Mobility limitations in the Medicare population: Prevalence and sociodemographic and clinical correlates. Journal of the American Geriatric Society, 53, 1217–1221.

    Article  Google Scholar 

  24. 24.

    Thomas, E., Wilkie, R., Peat, G., Hill, S., Dziedzic, K. S., & Croft, P. R. (2004). The North Staffordshire Osteoarthritis Project—NorStOP: Prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults. BMC Musculoskeletal Disorders, 5, 2.

    PubMed  Article  Google Scholar 

  25. 25.

    Office for National Statistics. (2000). Standard occupational classification 2000, Vol. 2. The coding index. London: The Stationery Office.

    Google Scholar 

  26. 26.

    Office for National Statistics. (2002). The National Statistics socio-economic classification: user manual. Version 1, 1. London: The Stationery Office.

    Google Scholar 

  27. 27.

    Thomas, R. (1999). Question bank commentary: Income. Retrieved June 15, 2007, from University of Surrey, Department of Sociology Web site:

  28. 28.

    Michael, Y. L., Berkman, L. F., Colditz, G. A., & Kawachi, I. (2001). Living arrangements, social integration, and change in functional health status. American Journal of Epidemiology, 153, 123–131.

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.

    PubMed  Article  Google Scholar 

  30. 30.

    Resnick, B., & Nahm, E. S. (2001). Reliability and validity testing of the revised 12-item Short-Form Health Survey in older adults. Journal of Nursing Measurement, 9, 151–161.

    PubMed  CAS  Google Scholar 

  31. 31.

    Haywood, K. L., Garratt, A. M., & Fitzpatrick, R. (2005). Quality of life in older people: A structured review of generic self-assessed health instruments. Quality of Life Research, 14, 1651–1668.

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Jinks, C., Lewis, M., Ong, B. N., & Croft, P. (2001). A brief screening tool for knee pain in primary care. 1. Validity and reliability. Rheumatology, 40, 528–536.

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Lacey, R. J., Lewis, M., & Sim, J. (2002). Validity and reliability of a questionnaire for upper quadrant pain and occupational risk factors. Rheumatology, 41, 45–46.

    Google Scholar 

  34. 34.

    Lacey, R. J., Lewis, M., Jordan, K., Jinks, C., & Sim, J. (2002). Inter-rater reliability assessment of the scoring of the body pain manikin. Rheumatology, 41, 52.

    Google Scholar 

  35. 35.

    Papageorgiou, A., Croft, P. R., Ferry, S., Jayson, M. I., & Silman, A. J. (1995). Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine, 20, 1889–1894.

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Birrell, F., Croft, P., Cooper, C., Hosie, G., Macfarlane, G. J., & Silman, A. (2000). Radiographic change is common in new presenters in primary care with hip pain. PCR Hip Study Group. Rheumatology, 39, 772–775.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    McHorney, C. A., Haley, S. M., & Ware, J. E., Jr. (1997). Evaluation of the MOS SF-36 Physical Functioning Scale (PF-10): II. Comparison of relative precision using Likert and Rasch scoring methods. Journal of Clinical Epidemiology, 50, 451–461.

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Brazier, J. E., Harper, R., Jones, N. M., O’Cathain, A., Thomas, K. J., Usherwood, T., & Westlake, L. (1992). Validating the SF-36 health survey questionnaire: New outcome measure for primary care. British Medical Journal, 305, 160–164.

    PubMed  CAS  Google Scholar 

  39. 39.

    Walters, S. J., Munro, J. F., & Brazier, J. E. (2001). Using the SF-36 with older adults: A cross-sectional community-based survey. Age and Ageing, 30, 337–343.

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Dawson, J., Linsell, L., Zondervan, K., Rose, P., Randall, T, Carr, A., & Fitzpatrick, R. (2004). Epidemiology of hip and knee pain and its impact on overall health status in older adults. Rheumatology (Oxford), 43, 497–504.

    Article  CAS  Google Scholar 

  41. 41.

    Bohannon, R. W., Brennan, P. J., Pescatello, L. S., Marschke, L., Hasson, S., & Murphy, M. (2004). Using self-report and speed to screen for gait limitations. Physical and Occupational Therapy Geriatrics, 23, 1–8.

    Article  Google Scholar 

  42. 42.

    Peterson, B., & Harrell, F. E. (1990). Partial proportional odds models for ordinal response variables. Applied Statistics, 39, 205–217.

    Article  Google Scholar 

  43. 43.

    StataCorp. (2005). Stata statistical software: Release 9.0. College Station, TX: Stata Corporation.

    Google Scholar 

  44. 44.

    Williams, R. (2006). Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata Journal, 6, 58–82.

    Google Scholar 

  45. 45.

    SPSS Inc. (2005). SPSS for Windows. Release 14.0.0. Chicago, IL: SPSS Inc.

    Google Scholar 

  46. 46.

    Iezzoni, L. I., McCarthy, E. P., Davis, R. B., & Siebens, H. (2001). Mobility difficulties are not only a problem of old age. Journal of General Internal Medicine, 16, 235–243.

    PubMed  Article  CAS  Google Scholar 

  47. 47.

    Arber, S., & Cooper, H. (1999). Gender differences in health in later life: The new paradox? Social Science & Medicine, 48, 61–76.

    Article  CAS  Google Scholar 

  48. 48.

    Murtagh, K. N., & Hubert, H. B. (2004). Gender differences in physical disability among an elderly cohort. American Journal of Public Health, 94, 1406–1411.

    PubMed  Article  Google Scholar 

  49. 49.

    Dionne, C. E., Von Korff, M., Koepsell, T. D., Deyo, R. A., Barlow, W. E., & Checkoway, H. (2001). Formal education and back pain: A review. Journal of Epidemiology and Community Health, 55, 455–468.

    PubMed  Article  CAS  Google Scholar 

  50. 50.

    Gill, T. M., Allore, H. G., Hardy, S. E., & Guo, Z. (2006). The dynamic nature of mobility disability in older persons. Journal of the American Geriatric Society, 54, 248–254.

    Article  Google Scholar 

  51. 51.

    Hardy, S. E., Dubin, J. A., Holford, T. R., & Gill, T. M. (2005). Transitions between states of disability and independence among older persons. American Journal of Epidemiology, 161, 575–584.

    PubMed  Article  Google Scholar 

  52. 52.

    Adamson, J., Hunt, K., & Ebrahim, S. (2003). Association between measures of morbidity and locomotor disability: Diagnosis alone is not enough. Social Science & Medicine, 57, 1355–1360.

    Article  Google Scholar 

Download references


This study is supported financially by a Programme Grant awarded by the Medical Research Council, UK (grant code: G9900220), and by funding secured from the North Staffordshire Primary Care R&D Consortium for NHS Service Support Costs. The authors would like to thank the Keele GP Research Partnership, the administrative staff at Keele University’s Primary Care Musculoskeletal Research Centre and the general practices from the North Staffordshire Primary Care Research Consortium.

Author information



Corresponding author

Correspondence to Sara Mottram.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mottram, S., Peat, G., Thomas, E. et al. Patterns of pain and mobility limitation in older people: cross-sectional findings from a population survey of 18,497 adults aged 50 years and over. Qual Life Res 17, 529–539 (2008).

Download citation


  • Lower limb pain
  • Mobility limitation
  • North Staffordshire Osteoarthritis Project (NorStOP)
  • Older adults
  • Partial proportional odds model