Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis: An Analysis Across 6 European Cohorts

EPOSA Group

Research output: Contribution to journalArticleAcademicpeer-review

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 pain severity as well as 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 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 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% confidence interval [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. Perspective: This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.

Original languageEnglish
Pages (from-to)690-698
Number of pages9
JournalJournal of Pain
Volume19
Issue number6
DOIs
Publication statusPublished - 1 Jun 2018

Cite this

@article{beb84a88d50a42abaec54eeb3a559d2f,
title = "Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis: An Analysis Across 6 European Cohorts",
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 pain severity as well as 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 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 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{\%} confidence interval [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. Perspective: This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.",
keywords = "anxiety symptoms, depressive symptoms, older persons, Osteoarthritis, pain variability",
author = "{EPOSA Group} and {de Koning}, {Elisa J.} and Timmermans, {Erik J.} and {van Schoor}, {N. M.} and Brendon Stubbs and {van den Kommer}, {Tessa N.} and Dennison, {E. M.} and Federica Limongi and Castell, {Maria Victoria} and Edwards, {M. H.} and Rocio Queipo and Cyrus Cooper and Paola Siviero and {van der Pas}, Suzan and Pedersen, {N. L.} and Mercedes S{\'a}nchez-Mart{\'i}nez and Deeg, {D. J.H.} and Denkinger, {Michael D.} and T. Nikolaus and M. Denkinger and R. Peter and F. Herbolsheimer and S. Maggi and S. Zambon and F. Limongi and M. Noale and P. Siviero and Deeg, {D. J.H.} and {van der Pas}, Suzan and {van Schoor}, {N. M.} and Schaap, {L. A.} and Timmermans, {Erik J.} and P. Lips and Otero and Castell, {M. V.} and M. Sanchez-Martinez and Pedersen, {N. L.} and Dennison, {E. M.} and C. Cooper and Edwards, {M. H.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1016/j.jpain.2018.02.006",
language = "English",
volume = "19",
pages = "690--698",
journal = "Journal of Pain",
issn = "1526-5900",
publisher = "Churchill Livingstone",
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}

Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis : An Analysis Across 6 European Cohorts. / EPOSA Group.

In: Journal of Pain, Vol. 19, No. 6, 01.06.2018, p. 690-698.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis

T2 - An Analysis Across 6 European Cohorts

AU - EPOSA Group

AU - de Koning, Elisa J.

AU - Timmermans, Erik J.

AU - van Schoor, N. M.

AU - Stubbs, Brendon

AU - van den Kommer, Tessa N.

AU - Dennison, E. M.

AU - Limongi, Federica

AU - Castell, Maria Victoria

AU - Edwards, M. H.

AU - Queipo, Rocio

AU - Cooper, Cyrus

AU - Siviero, Paola

AU - van der Pas, Suzan

AU - Pedersen, N. L.

AU - Sánchez-Martínez, Mercedes

AU - Deeg, D. J.H.

AU - Denkinger, Michael D.

AU - Nikolaus, T.

AU - Denkinger, M.

AU - Peter, R.

AU - Herbolsheimer, F.

AU - Maggi, S.

AU - Zambon, S.

AU - Limongi, F.

AU - Noale, M.

AU - Siviero, P.

AU - Deeg, D. J.H.

AU - van der Pas, Suzan

AU - van Schoor, N. M.

AU - Schaap, L. A.

AU - Timmermans, Erik J.

AU - Lips, P.

AU - Otero,

AU - Castell, M. V.

AU - Sanchez-Martinez, M.

AU - Pedersen, N. L.

AU - Dennison, E. M.

AU - Cooper, C.

AU - Edwards, M. H.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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 pain severity as well as 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 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 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% confidence interval [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. Perspective: This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.

AB - 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 pain severity as well as 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 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 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% confidence interval [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. Perspective: This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.

KW - anxiety symptoms

KW - depressive symptoms

KW - older persons

KW - Osteoarthritis

KW - pain variability

UR - http://www.scopus.com/inward/record.url?scp=85044259015&partnerID=8YFLogxK

U2 - 10.1016/j.jpain.2018.02.006

DO - 10.1016/j.jpain.2018.02.006

M3 - Article

VL - 19

SP - 690

EP - 698

JO - Journal of Pain

JF - Journal of Pain

SN - 1526-5900

IS - 6

ER -