Experiencing pain in middle adulthood and old age might be interpreted as a sign of aging and make people feel older, whereas feeling older has behavioral, motivational, and physiological consequences that might increase the risk of pain. We investigated between-person and within-person associations between pain, subjective age, and chronological age in middle-aged and older adults. Data from the German Ageing Survey were used (n = 13,874 who provided more than 32,000 observations, baseline mean age = 62.3 years). The observation period comprised up to 13 years (M = 4 years) and five (M = 2.4) measurement occasions. Based on the longitudinal multilevel regression models, we found significant between-person and within-person effects in both directions, which were small but robust when controlling for sociodemographic variables, depressive symptoms, and number of chronic diseases. At the between-person level, participants reporting overall more severe pain also felt older than others. Likewise, those who felt overall older than others reported more pain. At the within-person level, when participants experienced more pain than they usually do, they also reported feeling older than usual. Likewise, on measurement occasions when participants reported feeling older than usual, they reported more pain than usual. Additionally, those with overall stronger pain exhibited steeper age-related increases in their subjective age than those with less severe pain. Our findings suggest that an older subjective age may operate as both antecedent and consequence of pain, and pain might prompt a steeper increase in subjective age over time.
Public Significance StatementThe experience of pain might make individuals feel older, but how old individuals feel may also affect their pain sensations over time. This study is the first one to assess reciprocal between-person and withinperson associations of pain and subjective age, based on a large sample of middle-aged and older adults who were assessed up to five times over 13 years. Our findings suggest that significant between-person and within-person associations of stronger pain with an older subjective age and vice versa exist, and that individuals with overall stronger pain exhibit a more pronounced increase in subjective age with advancing chronological age compared to those with less pain.