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Within-person pain variability and mental health in older adults with osteoarthritis: An analysis across six European Cohorts

Within-person pain variability and mental health in older adults with osteoarthritis: An analysis across six European Cohorts
Within-person pain variability and mental health in older adults with osteoarthritis: An analysis across six European Cohorts
Pain is a key symptom of Osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of both pain severity and within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a six-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the WOMAC/AUSCAN, and intra-individual pain variability was measured using pain calendars assessed at baseline, 6 and 12-18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1-85 years). Moreover, older-old participants experienced fewer symptoms of anxiety (ratio=.85, 95% CI: .77-.94), depression (ratio=.90, 95% CI: .82-.98) and total affective symptoms (ratio=.87, 95% CI: .79-.94) if their pain fluctuated more. No such association was evident in younger-old participants (65-74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons.
1526-5900
de Koning, E.J.
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Timmermans, E.J.
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Van Schoor, N.M.
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Stubbs, B.
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van den Kommer, T.N.
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Dennison, E.M.
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Limongi, F.
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Castell, M.V.
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Edwards, M.H.
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Queipo, R.
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Cooper, C.
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Siviero, P.
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van der Pas, S.
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Pedersen, N.L.
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Sanchez-Martinez, M.
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Deeg, D.J.H.
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Denkinger, M.D.
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EPOSA group
de Koning, E.J.
39a86ee5-d984-42a2-91a0-e1d9b88bbfdd
Timmermans, E.J.
b1e2bcc4-4761-464d-a8b5-9677527e6c78
Van Schoor, N.M.
54108e9a-d965-45e0-86a2-a5eccb7f2890
Stubbs, B.
bccb7f03-83dc-4c03-82f7-58b89ce91bc5
van den Kommer, T.N.
a9de7a4e-ee41-49ca-ba33-709e135aae49
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Limongi, F.
1e97a365-9c0d-42e9-9435-6c02a13003f0
Castell, M.V.
3ee13f1f-711f-4d1e-825f-7b105fe4f7c7
Edwards, M.H.
8d92e1ef-8d4d-4efa-a183-305cd9ca1125
Queipo, R.
78db9781-df97-4150-8e6a-47102d8e1586
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Siviero, P.
913486a4-b176-4f3a-b889-50d50d630a30
van der Pas, S.
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Pedersen, N.L.
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Sanchez-Martinez, M.
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Deeg, D.J.H.
09f588f6-3441-4d48-a7ff-26b4b21ebac2
Denkinger, M.D.
644bf1fc-72e7-41de-983c-01781b8ec0d5

de Koning, E.J., Timmermans, E.J., Van Schoor, N.M., Stubbs, B., van den Kommer, T.N., Dennison, E.M., Limongi, F., Castell, M.V., Edwards, M.H., Queipo, R., Cooper, C., Siviero, P., van der Pas, S., Pedersen, N.L., Sanchez-Martinez, M., Deeg, D.J.H. and Denkinger, M.D. , EPOSA group (2018) Within-person pain variability and mental health in older adults with osteoarthritis: An analysis across six European Cohorts. Journal of Pain. (doi:10.1016/j.jpain.2018.02.006).

Record type: Article

Abstract

Pain is a key symptom of Osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of both pain severity and within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a six-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the WOMAC/AUSCAN, and intra-individual pain variability was measured using pain calendars assessed at baseline, 6 and 12-18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1-85 years). Moreover, older-old participants experienced fewer symptoms of anxiety (ratio=.85, 95% CI: .77-.94), depression (ratio=.90, 95% CI: .82-.98) and total affective symptoms (ratio=.87, 95% CI: .79-.94) if their pain fluctuated more. No such association was evident in younger-old participants (65-74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons.

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EPOSA paper accepted Jan2018 - Accepted Manuscript
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Accepted/In Press date: 13 February 2018
e-pub ahead of print date: 2 March 2018

Identifiers

Local EPrints ID: 418637
URI: https://eprints.soton.ac.uk/id/eprint/418637
ISSN: 1526-5900
PURE UUID: ad84e51f-af15-4071-994e-ca4903b87a73
ORCID for E.M. Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 13 Mar 2018 17:30
Last modified: 10 Dec 2019 05:30

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Contributors

Author: E.J. de Koning
Author: E.J. Timmermans
Author: N.M. Van Schoor
Author: B. Stubbs
Author: T.N. van den Kommer
Author: E.M. Dennison ORCID iD
Author: F. Limongi
Author: M.V. Castell
Author: M.H. Edwards
Author: R. Queipo
Author: C. Cooper ORCID iD
Author: P. Siviero
Author: S. van der Pas
Author: N.L. Pedersen
Author: M. Sanchez-Martinez
Author: D.J.H. Deeg
Author: M.D. Denkinger

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