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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., Stubbs, B., Dennison, E.M., Limongi, F., Castell, M.V., Edwards, M.H., Queipo, R., Cooper, C., 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: http://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: 18 Mar 2024 05:05

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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
Corporate Author: EPOSA group

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