Coexistence of Chronic Musculoskeletal Pain and Depressive Symptoms and Their Combined and Individual Effects on Onset of Disability in Older Adults: A Cohort Study.

OBJECTIVES

Coexistence of chronic musculoskeletal pain and depressive symptoms is common, and their combined effect on adverse events warrants investigation. The purpose of this study was to investigate the individual and combined effect of chronic musculoskeletal pain and depressive symptoms on the onset of disability, which is a crucial outcome in older adults.

DESIGN

A 1-year cohort study.

SETTING AND PARTICIPANTS

1251 community-dwelling older adults.

MEASUREMENTS

The number of chronic musculoskeletal pain sites was measured using a self-reported questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale-15. Disability was self-reported as any difficulty in basic activities of daily living. Incidence of disability was defined as any difficulty in performing 1 or more tasks at the follow-up assessment, that was absent at baseline.

RESULTS

Older adults with more chronic musculoskeletal pain sites tend to have depressive symptoms at baseline (P for trend < .001). Compared to older adults without both chronic musculoskeletal pain and depressive symptoms, older adults with both chronic multisite musculoskeletal pain and depressive symptoms have the higher risk for development of disability (adjusted odds ratio: 6.84, 95% confidence interval: 3.72 to 12.58), followed by older adults with chronic multisite musculoskeletal pain and without depressive symptoms (adjusted odds ratio: 2.13, 95% confidence interval: 1.35 to 3.37).

CONCLUSIONS/IMPLICATIONS: Simultaneous assessment of both chronic musculoskeletal pain and depressive symptoms may be useful for accurate prognosis and preventing disability in older adults.