The relationship between psychological factors and disabling musculoskeletal pain in community-dwelling older persons.
OBJECTIVE
To determine the relationship between two psychological factors (depressive symptoms and low functional self-efficacy) and the occurrence of disabling musculoskeletal pain in community-dwelling older persons.


METHODS
A 12-month prospective cohort study.


METHODS
Community-based.


METHODS
Two hundred twenty-six community-dwelling persons residing in the greater New Haven, Connecticut, region, aged 70 and older, who had a history of clinically evident musculoskeletal pain and were independent in bathing, walking, dressing, and transferring.


METHODS
Levels of depressive symptoms and functional self-efficacy were determined during a comprehensive baseline assessment along with information regarding participants' demographic, medical, and physical/cognitive status. The occurrence of disabling musculoskeletal pain, defined as staying in bed for at least one-half day or cutting down on one's usual activities due to joint or back pain, was ascertained during monthly interviews.


RESULTS
The mean number of months of disabling musculoskeletal pain, adjusted for baseline covariates, increased from the lowest to the highest quartile of depressive symptoms: 1.2 (95% confidence intervals = 0.8-1.7), 1.4 (1.0-2.0), 2.0 (1.5-2.8), 2.3 (1.7-3.1), respectively, P for trend =.002. The corresponding results for functional self-efficacy were (from highest to lowest quartile) 1.4 (1.0-2.0), 1.6 (1.2-2.2), 1.6 (1.2-2.2), 2.2 (1.6-3.0), P for trend =.068. There was no interaction between depressive symptoms and functional self-efficacy.


CONCLUSIONS
Depressive symptoms and, to a lesser extent, low functional self-efficacy were each associated with the occurrence of disabling musculoskeletal pain among community-dwelling older persons.
Reid
M Carrington
MC
Clinical Epidemiology Unit, VA Connecticut Healthcare System, West Haven, Connecticut, USA. mcr2004@med.cornell.edu
Williams
Christianna S
CS
Gill
Thomas M
TM
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003237:Connecticut; D003863:Depression / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000523:psychology*; D010146:Pain / Q000523:psychology*; D011446:Prospective Studies; D012044:Regression Analysis; D020377:Self Efficacy