Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Psychogeriatrics. 2020 Sep;20(5):602-607. doi: 10.1111/psyg.12537. Epub 2020 Mar 4.
Pain is a frequent phenomenon in old age. It has been shown that increases in pain are longitudinally associated with depressive symptoms. This strong link can be attenuated by coping strategies like resilience. However, to date, there is a lack of longitudinal studies, based on nationally representative samples that have examined whether flexible goal adjustment moderates the relation between pain and depressive symptoms. Thus, the purpose of this study was to identify whether there is a longitudinal association between pain and depressive symptoms, and to examine whether flexible goal adjustment moderates this link.
Longitudinal data (wave 3 and wave 4; 5582 observations) were taken from a sample (German Ageing Survey) which is nationally representative for middle-aged and older adults (40 years and over). A widely used pain measurement (single-item measure) served as the key independent variable. An instrument created by Brandstaedter and Renner was used to quantify flexible goal adjustment. The 15-item version of the Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms.
Linear fixed effects regressions demonstrated that an increase in pain was associated with an increase in depressive symptoms (β = 0.42, P < 0.001). Moreover, flexible goal adjustment significantly moderated this association (β = -0.39, P < 0.01). With regard to potential confounders, an increase in depressive symptoms was associated with increasing age and worsening self-rated health.
The study findings showed that increasing pain leads to more depressive symptoms using a longitudinal approach. In addition, flexible goal adjustment moderated this link. Therefore, programs aiming at improving flexible goal adjustment may assist in avoiding an increase in depressive symptoms alongside pain increases among older adults.
疼痛是老年人中常见的现象。已经表明，疼痛的增加与抑郁症状呈纵向相关。这种强烈的联系可以通过应对策略（如适应力）来减弱。然而，迄今为止，基于全国代表性样本的纵向研究缺乏，这些研究检验了灵活的目标调整是否可以调节疼痛与抑郁症状之间的关系。因此，本研究的目的是确定疼痛与抑郁症状之间是否存在纵向关联，并检验灵活的目标调整是否调节这种关联。
纵向数据（第 3 波和第 4 波；5582 个观察值）来自一个样本（德国老龄化研究），该样本对中年和老年人（40 岁及以上）具有全国代表性。一个广泛使用的疼痛测量（单项测量）作为关键自变量。Brandstaedter 和 Renner 创造的工具用于量化灵活的目标调整。使用 15 项版本的流行病学研究中心抑郁量表来衡量抑郁症状。
线性固定效应回归表明，疼痛增加与抑郁症状增加相关（β=0.42，P<0.001）。此外，灵活的目标调整显著调节了这种关联（β=-0.39，P<0.01）。关于潜在的混杂因素，抑郁症状的增加与年龄的增加和自我评估健康状况的恶化有关。
该研究结果表明，使用纵向方法，疼痛的增加会导致抑郁症状的增加。此外，灵活的目标调整调节了这种联系。因此，旨在改善灵活目标调整的计划可能有助于避免老年人疼痛增加时抑郁症状的增加。
