OBJECTIVES: To understand the complex interplay between older adults, exercise status, chronic pain status, and opioid use in the US, associations between these disparate characteristics need to be established and assessed for significant factors. This study aimed to (1) determine the prevalence of frequent exercise, and (2) identify associations between those who did frequent exercise versus those who did not, among US adults age ≥50 years with self-reported pain in the past four weeks who used an opioid.

METHODS: This study utilized a retrospective cross-sectional database design using 2020 Medical Expenditure Panel Survey (MEPS) data. Subjects were ≥50 years old, reporting pain in the past four weeks, reported use of at least one opioid in the past year, and were alive for the full calendar year. National estimates were calculated by adjusting for the complex MEPS design, and logistic regression models were used to assess significant associations between personal characteristics and self-reported exercise status. MEPS defines frequent exercise as 30 minutes of moderate to high intensity exercise at least five times per week.

RESULTS: A total of 843 individuals were eligible for the study for a weighted population of 10,596,166 individuals. Of these, 35.7% (95% confidence interval [CI] = 31.6%, 39.9%) self-reported that they were frequent exercisers. Frequent exercise was associated with self-perceived good physical health (adjusted odds ratio [AOR] = 2.279, 95% CI = 1.311, 3.964) and male sex (AOR = 1.754, 95% CI = 1.049, 2.932).

CONCLUSIONS: This study found that in 2020, only 3.7 million of the 10.5 million older US adults (≥50 years) with self-reported pain who had used an opioid considered themselves to be frequent exercisers while the rest did not. Factors associated with frequent exercise included good physical health and male sex, which can be used to identify areas for future interventions in this population.