title: Multisite pain, pain frequency and pain severity are associated with depression in older adults: results from the ActiFE Ulm study.
abstract: BACKGROUND
  there is ample literature showing pain and depression are related. However, different dimensions of pain have been used in former studies.
  
  
  OBJECTIVE
  the objective of the study was to compare the strength of the association of different pain dimensions with depression in older adults.
  
  
  METHODS
  assessments including evaluation of pain (severity, frequency, chronicity, quality, pain medication, painful body sites) and depression (measured by the Hospital Anxiety and Depression Scale) were performed in an observational study in community dwelling older adults (sample mean age 76, n = 1130) in Germany. The associations of different dimension of pain with depression were assessed using descriptive and multivariate methods.
  
  
  RESULTS
  the number of painful body areas was most significantly associated with self-reported late life depression (OR 1.20, CI 1.11-1.31). Pain severity and frequency (OR 1.12, CI 1.01-1.23 and OR 1.18, CI 1.01-1.37) were also associated with depression; quality and duration were not. Except for severity (OR 1.12, CI 1.02-1.24) associations of pain dimensions were strongly reduced when controlling for relevant confounders and gender was an effect modifier.
  
  
  CONCLUSIONS
  multisite pain, pain severity and frequency were the best predictors of late life depression. Clinicians should be especially aware of depressive disorders when older patients are complaining of pain in multiple areas across the body.
authors.affiliation: AGAPLESION Bethesda Clinic, Geriatric Center Ulm University; Zollernring 26, Ulm 89073, Germany.
authors.forename: Michael Dieter
authors.initials: MD
authors.lastname: Denkinger
authors.affiliation: AGAPLESION Bethesda Clinic, Geriatric Center Ulm University; Zollernring 26, Ulm 89073, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Lukas
authors.affiliation: AGAPLESION Bethesda Clinic, Geriatric Center Ulm University; Zollernring 26, Ulm 89073, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Nikolaus
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Peter
authors.affiliation: Developmental Science and Special Education, University of Siegen, Siegen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Franke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D005858:Germany; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: chronic pain; community dwelling; depression; older adults