Abstract
Objectives: This study aimed to reveal the prevalence, geographic variations, and determinants of pain among the Chinese older adult population and provide empirical strategies for pain management in older adults in China. Methods: A total of 21,346 Chinese residents aged ≥ 60 years from 31 provinces in mainland China participated in our survey. Standardized questionnaires were used to collect data on socioeconomic characteristics, lifestyle factors, and self-reported pain experiences. Multivariate logistic regression models were used to estimate the associations between individual socioeconomic status, chronic diseases, and pain. Results: The national prevalence of pain was 56.5% (95% CI: 55.9-57.1%), representing approximately 140 million Chinese older adults. The prevalence increased with aging and peaked at 80 years and older (61.00%, 95% CI: 59.30-62.70%). Women (62.36%, 95% CI: 61.47-63.25%), rural residents (61.27%, 95% CI: 60.34-62.20%), and those with no formal education (65.08%, 63.90-66.26%) had a higher prevalence than men (50.27%, 95% CI: 49.32-51.22%), urban residents (52.19%, 95% CI: 51.28-53.10%), and those with higher education levels, respectively. Provincial prevalence ranged from 38.98% in Shanghai to 72.75% in Gansu Province. The presence of chronic diseases significantly increased the odds of pain, with multimorbidity (three or more chronic diseases) showing the strongest association (OR = 11.380, 95% CI: 10.257-12.627). Conclusions and Implications: Pain was highly prevalent among older adults in China and varied geographically. Socioeconomic status, chronic diseases, and multimorbidity were strongly associated with pain prevalence. Our findings support prioritizing the reduction in gender and geographic disparities in China's pain management strategies. An integrated approach addressing both pain and chronic diseases should be urgently established in China's healthcare system for older adults.