Association Between Pain and Depression Among Older Adults in Europe: Results From the Aged in Home Care (AdHOC) Project: A Cross-Sectional Study
J Clin Psychiatry 2005;66(8):982-988
© Copyright 2014 Physicians Postgraduate Press, Inc.
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To assess the association between
pain and depression in a population of older adults.
Method: We conducted a cross-sectional study
using data from the Aged in Home Care (AdHOC) database, which
contains information on older adults receiving home care services
in 11 European countries from 2001 to 2003. Pain was defined as
any type of pain or discomfort manifested over the 7 days
preceding the assessment. Depression was defined as a score
> = 3 on the Minimum Data Set Depression Rating Scale.
Results: Mean age of 3976 subjects entering the
study was 82.3 years, and 2948 (74.1%) were women. Of the total
sample, 2380 subjects presented with pain (59.9%), but its
prevalence differed substantially among countries. Depression was
diagnosed in 181 (11.3%) of the 1596 participants without pain
and in 464 (19.5%) of the 2380 participants with pain
(p < .001). After adjusting for potential confounders, pain was
significantly associated with depression (odds ratio [OR] 1.76,
95% confidence interval [CI] = 1.43 to 2.17). This association
seemed to be modified by sex. Compared to male participants
without pain, women with pain were significantly more likely to
present with depression (OR = 1.77; 95% CI = 1.29 to 2.42), while no
significant difference was observed for women without pain
(OR = 0.86; 95% CI = 0.61 to 1.22) and men with pain (OR = 1.24; 95%
CI = 0.86 to 1.79). Among women, the association of pain and
depression became progressively more pronounced as pain severity,
pain frequency, and number of painful sites increased.
Conclusion: This study documented that in a
large sample of older adults living in the community, pain is
associated with depression, especially among women.