Abstract
BackgroundPain and depression are known to be associated in later life, and both have a negative effect on physical performance both separately and in combination. The nature of the relationships between pain intensity and depression in elderly persons experiencing pain is less clear. The objectives of this study were to explore which factors are associated with depressed mood in older people experiencing pain, and to test the hypothesis that older people experiencing pain are at risk of depressed mood according to the severity or frequency of their pain. In addition we explored whether other potentially modifiable factors might increase the risk of depressed mood in these persons.MethodsThe study is a secondary analysis of baseline data for four hundred and six community-dwelling non-disabled people aged 65 and over registered with three group practices in suburban London who had experienced pain in the past 4 weeks. Intensity and frequency of pain was measured using 24 item Geriatric Pain Measure (GPM) and the presence of depressive symptoms using the 5 item Mental Health Inventory. Risk for social isolation was measured using the 6 item Lubben Social Network scale and instrumental activities of daily living (IADL) were also measured.ResultsOverall 76 (19%) had depressed mood. Pain frequency and severity were not statistically significantly associated with depressed mood in this population. In multivariate analyses, significant predictors of the presence of depressive symptoms were difficulties with basic ADLs (OR 2.8, 95% CI 1.1.7.8), risk for social isolation (OR 4.1, 95% CI 1.8–9.3), and basic education only (OR 2.2, 95% CI 1.1–4.4).ConclusionOlder people experiencing pain are also likely to experience depression. Among those experiencing pain, social network and functional status seem to be more important predictors of depressive symptoms than the severity of pain. Further studies should evaluate whether improvement of social network and functional status might reduce depressive symptoms in older patients.
Highlights
Pain and depression are known to be associated in later life, and both have a negative effect on physical performance both separately and in combination
A recent survey of nearly 20,000 adults in five European countries found that 28% of those with one depressive symptom had chronic pain, whilst 43% of those with major depression reported chronic pain [1]
The Canadian Community Health Survey of 118 533 community-dwelling adults found that chronic back pain occurred in 20% of clinically depressed adults compared with 9% of the whole population, and that chronic back pain was the strongest predictor of major depression [2]
Summary
Pain and depression are known to be associated in later life, and both have a negative effect on physical performance both separately and in combination. Pain and clinical depression are known from other studies to be associated in later life [5], and both have a negative effect on physical performance both separately and in combination [6]. In our community study in London (which had the same study population as reported here) we found that 45% of women and 34% of men aged 65 and over reported pain in the previous four weeks, that pain had a profound impact on activities of daily living, and that there was a significant association between the experience of pain and depressed mood [7]. Other factors must be involved in the relationship between pain and depression, and this paper explores these factors
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