(220) Evaluation of the Effects of Pain and Depression on the Physical Functioning of Continuing Care Retirement Community Residents: Implications for the Treatment of Pain in Older Individuals

Abstract

Chronic pain is a major obstacle to a satisfying old age. With 35 million persons over age 65 in the U.S., and the number projected to double by 2030, chronic pain in the elderly is becoming a significant public health problem. A longitudinal study of 228 independently living retirement community (CCRC) residents was conducted to explore the relationships between pain, depression, and functional disability. The sample was predominantly age 75–84, the majority were female, and most had completed college. Self-report measures of pain (adaptation of McGill Pain Questionnaire), depression (Geriatric Depression Scale (GDS), and physical functioning (Self-reported physical performance, ADL, IADL, and 3 meter walking speed) were assessed. 79% of the sample reported pain within the past 2 weeks. 50% of these indicated pain limited their activities. Sub-threshold or major depression was diagnosed in 39%, and almost 23% reported both activity limiting pain and sub-threshold or more severe depression while 13% reported freedom from pain and depressive symptoms. For analyses, individuals in the worst quartiles of functional performance and walking speed at baseline were contrasted to all others; for ADL and IADL, those needing help were compared to those independent in activities. In univariate analyses, pain and depression were strongly related to physical performance; depression was related to ADL and walking speed. Multivariate analyses revealed an interaction effect in which the effects of pain depended on depression level. Individuals reporting activity limiting pain and elevated depressive symptoms, sub-threshold, or major depression were over 7 times more likely than non-depressed persons to be in the worst physical performance quarterly. This finding is statistically significant (P < 0.001). While pain and depression affect physical performance, depressive symptoms rather than pain appear more critical. When seeing older patients with pain complaints,... [ABSTRACT FROM AUTHOR] Copyright of Pain Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)