Depression and Longitudinal Frailty Trajectories in Middle-Aged and Older Adults with Chronic Pain: A 8-Year National Cohort Study in China.

IF 4.5 3区 心理学 Q2 PSYCHOLOGY, CLINICAL
Psychology Research and Behavior Management Pub Date : 2026-09-16 eCollection Date: 2026-01-01 DOI:10.2147/PRBM.S630081
Haotian Zhang, Aiqi Wang, Shun Wang, Guoyan Feng, Lu Wang, Liqin Deng
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Abstract

Background: Global population aging is accelerating, and pain and depression frequently co-occur in middle-aged and older adults. Frailty, an age-related clinical syndrome, markedly elevates the risks of falls, disability, hospitalization, and mortality. This study investigated whether comorbid depression affects long-term frailty trajectories in patients with chronic pain, to help identify high-risk populations and guide comprehensive interventions.

Methods: Based on 8 years of follow-up (2011-2018) from the nationally representative multi-stage probability sample of the China Health and Retirement Longitudinal Study (CHARLS), 4,778 participants aged 45 years and older with chronic pain were enrolled. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), with a total score ≥10 indicating depressive symptoms, and frailty was quantified by a 32-item Frailty Index (FI). Group-based trajectory modeling (GBTM) identified FI developmental trajectories, and multinomial logistic regression examined the association between depression and trajectory group membership.

Results: Three frailty trajectories were identified: Low Frailty Group, Moderate Frailty Group, and High Frailty Group. Overall, 61.3% of participants had comorbid depressive symptoms. Depressive symptoms were associated with significantly higher odds of the moderate (OR = 2.82, 95% CI 2.42-3.29) and high trajectories (OR = 6.57, 95% CI 5.18-8.34). Each 1-point CES-D-10 increment increased the odds by 11% and 19%, respectively. These associations remained stable across subgroups.

Conclusion: In middle-aged and older adults with chronic pain, depression was associated with worsening frailty trajectories. Routine depression screening integrated with mental health care for chronic pain and frailty may help slow frailty progression and reduce disability burden.

中国中老年慢性疼痛患者的抑郁和纵向虚弱轨迹:一项为期8年的国家队列研究。
背景:全球人口老龄化正在加速,疼痛和抑郁经常在中老年人群中同时发生。虚弱是一种与年龄相关的临床综合征,显著增加跌倒、残疾、住院和死亡的风险。本研究探讨了共病抑郁症是否会影响慢性疼痛患者的长期衰弱轨迹,以帮助识别高危人群并指导综合干预。方法:基于中国健康与退休纵向研究(CHARLS)具有全国代表性的多阶段概率样本的8年随访(2011-2018),纳入了4,778名年龄在45岁及以上的慢性疼痛患者。采用10项流行病学研究中心抑郁量表(CES-D-10)评估抑郁症状,总分≥10表示抑郁症状,虚弱程度采用32项虚弱指数(FI)量化。基于群体的轨迹模型(GBTM)确定了FI的发展轨迹,多项逻辑回归研究了抑郁与轨迹群体成员之间的关系。结果:确定了三种衰弱轨迹:低衰弱组,中度衰弱组和高度衰弱组。总体而言,61.3%的参与者有抑郁共病症状。抑郁症状与中度(OR = 2.82, 95% CI 2.42-3.29)和重度(OR = 6.57, 95% CI 5.18-8.34)相关。CES-D-10每增加1分,几率分别增加11%和19%。这些关联在亚组中保持稳定。结论:在慢性疼痛的中老年患者中,抑郁与衰弱轨迹的恶化有关。常规抑郁症筛查与慢性疼痛和虚弱的精神卫生保健相结合,可能有助于减缓虚弱的进展,减轻残疾负担。
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来源期刊
CiteScore
4.50
自引率
4.70%
发文量
341
审稿时长
16 weeks
期刊介绍: Psychology Research and Behavior Management is an international, peer-reviewed, open access journal focusing on the science of psychology and its application in behavior management to develop improved outcomes in the clinical, educational, sports and business arenas. Specific topics covered in the journal include: -Neuroscience, memory and decision making -Behavior modification and management -Clinical applications -Business and sports performance management -Social and developmental studies -Animal studies The journal welcomes submitted papers covering original research, clinical studies, surveys, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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