# Diverging Effects of Closeness in Older Adults with Chronic Low Back Pain and Spousal Caregivers

> **NIH NIH R01** · PENNSYLVANIA STATE UNIVERSITY, THE · 2022 · $571,058

## Abstract

PROJECT SUMMARY/ABSTRACT
 The majority of older Americans live with chronic health conditions, and pain is the most common physical
symptom experienced across conditions. Spouses of older adults with chronic pain are caregivers in a broad
sense, and often provide assistance with daily activities; however, ongoing exposure to patients’ suffering is
likely to take a toll on the health and well-being of these caregivers. Moreover, our recent research suggests
that older spouses in a close marital relationship are more affected by their partner’s pain than spouses in a
less close relationship. This intriguing finding suggests that closeness may be good for the relationship but bad
for spouses when patients are in more pain. The proposed project will test for these divergent effects and their
longer-term implications in a sample of 144 older adults with chronic low back pain (CLBP), due to the high
prevalence and treatment-related costs of this condition in the Medicare population. Patients and caregivers
will report on their daily experiences twice per day for 30 days using tablet computers. They will also complete
in-person interviews and physical function assessments every 6 months over 2 years. Aim 1 is to examine
prospective effects of patients’ daily pain experience (severity, interference, catastrophizing) on spousal
caregivers’ distress (i.e., reactivity) and controlling responses, and divergent effects of daily closeness. We
predict that patients’ pain experience will have stronger associations with spouses’ subsequent distress, and
spouses will respond with more solicitousness and pressure, on days of high closeness than on low closeness
days. In addition, we predict greater daily closeness will be associated with more marital satisfaction that day,
for both partners. Bi-directional and cross-day effects also will be examined in tests of these hypotheses. Aim 2
will use multilevel latent growth curve modeling to link daily caregiver emotional reactivity and controlling
responses with longer-term outcomes for both partners. Our prediction is that spouses who are more
distressed by patients’ pain will have more depressive symptoms over 2 years compared to those who are less
distressed. In addition, we expect that patients whose spouse is more controlling in response to patients’ pain
will have worse physical function, greater disability, and increased health care utilization over 2 years
compared to those whose spouse is less controlling. Significance of this study lies in: 1) improved
understanding of the impact of late-life pain on spousal caregivers’ well-being; 2) identification of longer-term
consequences of dynamic, dyadic experiences for both patients and caregivers; and 3) findings that will be
used to create a couple-oriented intervention for CLBP in future research. Areas of innovation include a novel
conceptualization of relationship closeness that will reveal its advantages and disadvantages for couples living
with chronic pain, a ...

## Key facts

- **NIH application ID:** 10318989
- **Project number:** 5R01AG063241-03
- **Recipient organization:** PENNSYLVANIA STATE UNIVERSITY, THE
- **Principal Investigator:** LYNN M. MARTIRE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $571,058
- **Award type:** 5
- **Project period:** 2020-02-15 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10318989

## Citation

> US National Institutes of Health, RePORTER application 10318989, Diverging Effects of Closeness in Older Adults with Chronic Low Back Pain and Spousal Caregivers (5R01AG063241-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10318989. Licensed CC0.

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