Saturday, May 17, 2025
5/17/2025
High physical activity in older adults with pain: behavioral and neural drivers of pain resilience - Project Summary/Abstract Chronic musculoskeletal pain in older age is common, costly, and without a cure. A frequent and detrimental consequence of pain is lower physical activity (PA). This is problematic for older adults because lower PA increases risks of disability, depression, and dementia. My long-term goal is to understand how to reduce the detrimental impact of pain on PA in older adults. Our preliminary work and others suggest that some older adults with pain can have higher levels of PA, even with similar levels of pain, and are thus seemingly resilient to the impact of pain on PA. It is unclear why this might be; pain characteristics such as severity, location, and duration do not fully explain such pain resilience. Emerging evidence suggests that motivation is an important predictor of PA; studies indicate a positive role for neural and behavioral measures of motivation, such as cortico-striatal limbic activity and self-reported perception of energy and difficulty getting going. However, previous research has focused on populations of younger adults without pain in cross-sectional designs. What is not known, and I propose to address here, is whether neural and behavioral measures of motivation protect against PA decline similarly in older adults with and without pain. I hypothesize that pain resilient older adults have higher levels of cortico-striatal limbic network activity and behavioral measures of motivation compared to non-resilient older adults. The proposed study leverages the Health, Aging and Body Composition Study, a biracial cohort of 3,075 older adults (ages 70-79 at entry, 42% Black, 52% women) with existing longitudinal data of behavioral measures of motivation, pain, and PA over 13 years, as well as extensive measures of other contributors of PA (e.g., comorbidities, polypharmacy). Resting state functional connectivity of limbic network activity was collected in 315 participants at year 10. The results of this study may help identify modifiable protective factors and inform future targets to promote pain resiliency in older adults. This research project is synergistic with my training plan to mature three critical competencies: (1) advanced skills in neuroepidemiological research methods; (2) translational experience in the neural correlates of pain and motivation; (3) communication with scientific communities and the public. I have formed an exceptional inter-disciplinary mentorship team that is well equipped to support this proposal and my training. Through this funding, I will further develop the necessary foundation to become an independent physician-epidemiologist improving the care of chronic pain in older adults in innovative and evidence-based ways.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).