Reciprocal relationship between pain and depression in older adults : evidence from the English longitudinal study of ageing

Background: Previous cross-sectional studies have shown an association between pain and depression, but it is unclear which comes first. Our objectives were to determine the temporal relationship between pain and depression, and to investigate whether these two syndromes share predictors. Methods: A 2-year, population-based, prospective, observational study of 3654 older adults aged 65 and above selected from the English Longitudinal Study of Ageing Waves 1 and 2. Pain, 8-item CES-D, socio-economic variables, health indicators, and social support were assessed. Results: Logistic regression analyses revealed that pain at baseline was an independent predictor of becoming depressed 2 years later and depression at baseline was a predictor of developing pain at 2 years. Individuals with mobility disability and poor sight were at risk of becoming depressed as well as developing pain. Moreover, older age, poor sight and mobility disability were common predictors for pain and depression after baselines of both syndromes were adjusted. Conclusion: Individuals who develop pain or depression are at risk for developing the other, with a spiraling risk of pain and depression. Because pain and depression share predictors, individuals who are at high risk of developing these two outcomes can be identified by aged care service practitioners.