321: Physical, Cognitive, and Gut Microbiome Differences in Older Adults with Single vs Multisite Pain

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: While multisite pain is common among older adults, limited evidence exists regarding how these individuals differ from those with no pain or pain in only one location. This study aimed to compare community-dwelling older adults with multisite pain to those with no or single-site pain in terms of physical function, cognitive performance, and gut microbiota composition.

Methods: A cross-sectional study was conducted with 114 adults aged ≥65 years living in Kagamiishi Town, Japan. Participants were categorized into two groups: the "No or One Pain" group (n = 81), including individuals with no pain or pain in one location, and the "Multisite Pain" group (n = 33).
Assessments included the Kihon Checklist, Lubben Social Network Scale, Montreal Cognitive Assessment, and physical performance measures. Gut microbiota composition was analyzed using 16S rRNA gene sequencing targeting the V1–V2 region. Alpha diversity was evaluated with the Shannon index. Group differences were assessed using the Kruskal-Wallis test and linear discriminant analysis effect size (LEfSe).

Results: The Multisite Pain group had significantly higher rates of decline in motor function (p < 0.01) and oral function (p < 0.05) compared to the No or One Pain group. The prevalence of depressive symptoms was markedly greater in the Multisite Pain group (p < 0.01). Frailty was also more frequent in the Multisite Pain group (p < 0.01). Knee extension strength was significantly lower in this group (p < 0.01). No significant group differences were observed in cognitive function. Gut microbiota analysis revealed significantly reduced alpha diversity in the Multisite Pain group.

Conclusions: Multisite pain in older adults is associated with higher rates of depression, frailty, reduced physical function, and decreased gut microbial diversity. The enrichment of specific bacterial taxa suggests that alterations in the gut microbiome may contribute to the pathophysiology of multisite pain.

References: Minerbi A, Gonzalez E, Brereton NJB, Anjarkouchian A, Dewar K, Fitzcharles M-A, Chevalier S, Shir Y (2019) Altered microbiome composition in individuals with fibromyalgia. Pain 160:2589–2602.

Shiro Y, Arai Y-C, Nakaso Y, Sakurai H, Inoue M, Owari K, et al (2025) Differences in gut microbiota composition depending on the site of pain in patients with chronic pain. J Pain Res 18:769–782.

Presenting Author: Shoji Yabuki
Submitting Author: Shoji Yabuki

Senior Author: Shoji Yabuki

IASP 2026 Global Year theme of Neuropathic Pain: No

• Toshimasa Sone: OT - Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Toshimi Sato: PT - Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Jun Yabuki: PT - Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
• Tatsuya Nakanowatari: PT - Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Masayuki Hoshi: PT - Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Kanako Okazaki: PT - Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Kazuaki Iokawa: OT - Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Hiroshi Hayashi: MD - Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Akihiko Asao: OT - Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Natsumi Kimura: OT - Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Maki Ogasawara: OT - Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Yuko Horikoshi: MT - Department of Clinical Laboratory Sciences, Fukushima Medical University School of Health Sciences, Fukushima City, Japan
• Yoshitaka Shiba: PT - Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Japan