Association between pain intensity and depressive symptoms in community-dwelling adults: longitudinal findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Eur Geriatr Med. 2023 Oct;14(5):1111-1124. doi: 10.1007/s41999-023-00835-5. Epub 2023 Jul 14.

Abstract

Purpose: To investigate the longitudinal associations between pain and depressive symptoms in adults.

Methods: Prospective cohort study on data from 28,515 community-dwelling adults ≥ 50 years, free from depression at baseline (Wave 5), with follow-up in Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Significant depressive symptoms were defined by a EURO-D score ≥ 4. The longitudinal association between baseline pain intensity and significant depressive symptoms at follow-up was analysed using logistic regression models; odds ratios (ORs) and confidence intervals (CI) were calculated, adjusting for socio-demographic and clinical factors, physical inactivity, loneliness, mobility and functional impairments.

Results: Mean age was 65.4 years (standard deviation 9.0, range 50-99); 14,360 (50.4%) participants were women. Mean follow-up was 23.4 (standard deviation 3.4) months. At baseline, 2803 (9.8%) participants reported mild pain, 5253 (18.4%) moderate pain and 1431 (5.0%) severe pain. At follow-up, 3868 (13.6%) participants-1451 (10.3%) men and 2417 (16.8%) women-reported significant depressive symptoms. After adjustment, mild, moderate and severe baseline pain, versus no pain, were associated with an increased likelihood of significant depressive symptoms at follow-up: ORs (95% CI) were 1.20 (1.06-1.35), 1.32 (1.20-1.46) and 1.39 (1.19-1.63), respectively. These associations were more pronounced in men compared to women, and consistent in participants aged 50-64 years, those without mobility or functional impairment, and those without loneliness at baseline.

Conclusion: Higher baseline pain intensity was longitudinally associated with a greater risk of significant depressive symptoms at 2-year follow-up, in community-dwelling adults without baseline depression.

Keywords: Ageing; Depressive symptoms; Loneliness; Pain; Population-based prospective study; Sex-differences.

MeSH terms

  • Aged
  • Aging
  • Depression* / epidemiology
  • Europe / epidemiology
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Independent Living
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pain / epidemiology
  • Pain Measurement
  • Prospective Studies
  • Retirement*