[Purpose] Hypervigilance to pain is an important aspect of the fear-avoidance model of pain that may be associated with disability more than other psychological factors examined. The aim of the study was to investigate how hypervigilance to pain influences disability compared with other psychological factors examined. [Subjects and Methods] The subjects of this study were 50 elderly patients with chronic pain (7 men and 43 women, 80.3 ± 7.8 years). To assess the pain level, the Numerical Rating Scale (NRS) was used. To assess psychological factors, the Hospital Anxiety and Depression Scale (HADS), the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Pain Vigilance Awareness Questionnaire (PVAQ) were used. To assess activities of daily living, the Pain Disability Assessment Scale (PDAS) was used. A multiple regression analysis (stepwise method) was performed with the PDAS as the dependent variable, and the NRS, HADS-anxiety, HADS-depression, TSK, PCS-rumination, PCS-magnification, PCS-helplessness, and PVAQ, as the independent variables. [Results] The results of a multiple regression analysis showed that the PDAS scores were affected by the PVAQ and NRS scores. [Conclusion] Hypervigilance influenced disability more than other psychological factors examined.