Body Pain and Depressive Symptoms: Patterns and Associations in Middle-Aged and Older Chinese Adults.

Depressive symptoms (DS) and body pain are prevalent conditions that significantly impact the quality of life of older adults, often co-occurring with chronic diseases. This study aimed to explore the patterns of body pain characteristics and their association with DS among middle-aged and older Chinese adults. This cross-sectional study analysed data from 16,039 participants aged ≥45 years in the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS). DS were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale (CESD-10). Body pain characteristics included pain severity and location. Multiple linear regression and mediation analyses were conducted to examine the relationships between chronic diseases, body pain, and DS. Among participants, 5442 (33.9%) reported DS (CESD-10 score ≥12). The DS group showed significantly higher body pain severity (2.66 ± 1.42 vs. 1.84 ± 1.11, < 0.001) and more painful body parts (5.06 ± 3.87 vs. 3.68 ± 3.03, < 0.001) compared to the non-depressive group. Both pain severity and number of pain sites were independently associated with higher CESD-10 scores. Mediation analysis revealed that body pain severity mediated 29.0% of the total effect between chronic diseases and DS. Body pain plays a significant mediating role in the relationship between chronic diseases and DS among middle-aged and older Chinese adults. These findings emphasize the importance of implementing comprehensive healthcare approaches that integrate pain management with mental health support in primary care settings.