Relationship between chronic pain, depressive symptoms, and functional disability in community-dwelling older adults: mediating role of frailty.

Autor: Borim FSA; Programa de pós-graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil., Assumpção D; Programa de pós-graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil., Yassuda MS; Programa de pós-graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.; Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil., Costa HTM; Group of Investigation on Multimorbidity and Mental Health in Aging, Department of Internal Medicine, Faculdade de Medicina de Jundiaí, São Paulo, SP, Brazil., Batistoni SST; Programa de pós-graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.; Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil., Neri AL; Programa de pós-graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil., Voshaar RCO; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.; University of Groningen, Groningen, The Netherlands., Aprahamian I; Group of Investigation on Multimorbidity and Mental Health in Aging, Department of Internal Medicine, Faculdade de Medicina de Jundiaí, São Paulo, SP, Brazil.; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Einstein (Sao Paulo, Brazil) [Einstein (Sao Paulo)] 2023 Dec 15; Vol. 21, pp. eAO0284. Date of Electronic Publication: 2023 Dec 15 (Print Publication: 2023).
DOI: 10.31744/einstein_journal/2023AO0284
Abstrakt: Background: Borim et al. showed that older adults with chronic pain exhibited more depressive symptoms and frailty components. Depressive symptoms were associated with more frailty components, and those with more depressive symptoms and frailty faced greater limitations in IADL performance. Frailty appears to mediate the pathway from chronic pain to functional impairment Chronic pain is directly associated with depressive symptoms and frailty. Chronic pain is not directly associated with functional disability. Depression and frailty are both directly associated with functional disabilities. Frailty mediates the association between chronic pain and functional disability. Depression; Disability evaluation; Frailty; Frail elderly.
Objective: To evaluate the direct and indirect effects of chronic pain, depressive symptoms, frailty components, and functional disability through a pathway analysis approach in a sample of community-dwelling older adults.
Methods: Data of 419 participants were cross-sectionally evaluated for the presence of depressive symptoms (Geriatric Depression Scale [15 items]), physical frailty components (phenotype criteria), chronic pain, and limitations in performing instrumental activities of daily living (functional disability scale by Lawton and Brody). Structural equation modeling via path analysis was used to explore the direct and indirect effects among these four variables. Statistical significance was set at p<0.05.
Results: Of the total participants, 69.8% were women and 59.3% had low education (1-4 years); the mean age was 80.3±4.6 years. Chronic pain and depressive symptoms were directly related and were associated to frailty. The number of frailty components and depressive symptoms were directly associated with functional disability. Frailty had an indirect effect on the association between chronic pain, depressive symptoms, and functional disabilities.
Conclusion: The pathway from chronic pain and depressive symptoms to functional disability is potentially mediated by the number of frailty components.
Databáze: MEDLINE
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