Bothersome and activity-limiting pain in community-dwelling older adults with versus without stroke: a cross-sectional analysis of the National Health and Aging Trends study (2011–2024)

Introduction Stroke and pain are common health challenges among older adults. However, limited research has examined the burden of pain among community-dwelling older adults with a history of stroke in the United States of America (USA). This study aimed to estimate the prevalence of bothersome and activity-limiting pain and examine the association between stroke history and pain outcomes among older adults in the USA.Materials and methods This cross-sectional secondary analysis used publicly available data from Rounds 1–14 of the National Health and Aging Trends Study (NHATS), conducted from 2011 to 2024. The study included adults aged ≥ 65 years and compared participants with and without a self-reported physician-diagnosed history of stroke. Pain outcomes were derived from standardized NHATS interview data and included bothersome pain and activity-limiting pain. Demographic, clinical, psychological, physical, and sleep-related variables were obtained from the NHATS dataset. Survey-weighted multivariable logistic regression was used to examine the associations between stroke history and pain outcomes after adjustment for relevant covariates.Results Among 12,797 participants, 2,235 (15.71%) had a history of stroke, and 10,562 (84.29%) did not. The prevalence of bothersome pain was higher among participants with stroke than among those without stroke (60.77% vs. 54.66%; p = .003). Similarly, activity-limiting pain was more prevalent among participants with stroke (62.83% vs. 52.00%; p < .001). After adjustment for demographic, clinical, psychological, physical, and sleep-related factors, stroke remained independently associated with bothersome pain (OR 1.30, 95% CI 1.02–1.66; p = .034) and activity-limiting pain (OR 1.20, 95% CI 1.04–1.38; p = .013).Conclusions Pain represents a substantial burden among U.S. older adults with a history of stroke. Stroke was independently associated with both bothersome and activity-limiting pain, highlighting the importance of comprehensive pain assessment and management within geriatric stroke rehabilitation.