# High physical activity in older adults with pain: behavioral and neural drivers of pain resilience

> **NIH NIH F30** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $54,320

## Abstract

Project Summary/Abstract
 Chronic musculoskeletal pain in older age is common, costly, and without a cure. A frequent and
detrimental consequence of pain is lower physical activity (PA). This is problematic for older adults
because lower PA increases risks of disability, depression, and dementia. My long-term goal is to
understand how to reduce the detrimental impact of pain on PA in older adults.
 Our preliminary work and others suggest that some older adults with pain can have higher levels of
PA, even with similar levels of pain, and are thus seemingly resilient to the impact of pain on PA. It is
unclear why this might be; pain characteristics such as severity, location, and duration do not fully explain
such pain resilience. Emerging evidence suggests that motivation is an important predictor of PA; studies
indicate a positive role for neural and behavioral measures of motivation, such as cortico-striatal limbic
activity and self-reported perception of energy and difficulty getting going. However, previous research has
focused on populations of younger adults without pain in cross-sectional designs.
 What is not known, and I propose to address here, is whether neural and behavioral measures of
motivation protect against PA decline similarly in older adults with and without pain. I hypothesize that pain
resilient older adults have higher levels of cortico-striatal limbic network activity and behavioral measures
of motivation compared to non-resilient older adults. The proposed study leverages the Health, Aging and
Body Composition Study, a biracial cohort of 3,075 older adults (ages 70-79 at entry, 42% Black, 52%
women) with existing longitudinal data of behavioral measures of motivation, pain, and PA over 13 years,
as well as extensive measures of other contributors of PA (e.g., comorbidities, polypharmacy). Resting
state functional connectivity of limbic network activity was collected in 315 participants at year 10. The
results of this study may help identify modifiable protective factors and inform future targets to promote
pain resiliency in older adults.
 This research project is synergistic with my training plan to mature three critical competencies: (1)
advanced skills in neuroepidemiological research methods; (2) translational experience in the neural
correlates of pain and motivation; (3) communication with scientific communities and the public. I have
formed an exceptional inter-disciplinary mentorship team that is well equipped to support this proposal and
my training. Through this funding, I will further develop the necessary foundation to become an
independent physician-epidemiologist improving the care of chronic pain in older adults in innovative and
evidence-based ways.

## Key facts

- **NIH application ID:** 10822437
- **Project number:** 1F30AG085921-01
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Kailyn Faye Witonsky
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $54,320
- **Award type:** 1
- **Project period:** 2024-01-18 → 2026-01-17

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10822437

## Citation

> US National Institutes of Health, RePORTER application 10822437, High physical activity in older adults with pain: behavioral and neural drivers of pain resilience (1F30AG085921-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10822437. Licensed CC0.

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