Pain Status and Disability in Activities of Daily Living Among Older Adults in China: Evidence From CHARLS 2020

<b>Background:</b> Pain status is a common concern among older adults and has been linked to functional limitations. This study aimed to examine the association between pain status and disabilities risk in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in older adults in China, using data from the 2020 China Health and Retirement Longitudinal Study (CHARLS). <b>Methods:</b> A cross-sectional analysis was conducted using data from 8102 participants aged 60 and older from the 2020 CHARLS. Univariate and multivariate binary logistic regression analyses were performed to assess the association between pain status and BADL/IADL disabilities. We further examined the contribution of each covariate and categorized participants by pain location and number of pain sites. Subgroup analyses were conducted to examine the consistency of findings across demographic and health-related factors. <b>Results:</b> Pain status was significantly associated with higher odds of both BADL and IADL disabilities (<i>p</i> < 0.05), even after adjusting for covariates. Self-rated health and depressive symptoms exerted the greatest influence on the OR values. Pain in any anatomical region, particularly when present at multiple sites, was associated with increased odds of disability. Head and neck pain was specifically associated with IADL disability, while pain in the upper limbs, torso, and lower limbs was associated with both BADL and IADL disabilities. Subgroup analyses confirmed the robustness of these associations. <b>Conclusions:</b> Pain status, especially multisite pain, is significantly associated with BADL and IADL disabilities in older Chinese adults. Although causality cannot be inferred due to the study's cross-sectional design, these findings underscore the importance of addressing pain alongside other health and psychological factors when developing strategies to support functional independence in aging populations.