Associations among pain, depression, and functional limitation in low-income, home-dwelling older adults: An analysis of baseline data from CAPABLE.
Patrick D Smith, Kathleen Becker, Laken Roberts and 2 others
PMID 27245384WHAT IT FOUND
In low-income home-dwelling older adults, higher depressive symptoms and pain interference were linked to more difficulty with daily activities.
Depression was linked to part of the pain-function relationship, but this baseline analysis does not show treatment improves function.
Key findings
01Higher depressive symptom scores were associated with greater difficulty with daily activities (p = 0.00).
02Pain interference explained the greatest variation in daily-activity limitation scores among variables studied (adjusted R² = 0.07).
03In the mediation models, depressive symptoms fully mediated the link between current pain intensity and daily-activity limitation, and partially mediated the link between pain interference and daily-activity limitation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The data are cross-sectional baseline associations, so they cannot show whether pain, depression, or functional limitation caused another. The sample was low-income, mostly African-American, mostly female, and all from Baltimore City, so results may not apply to other older adults. This analysis did not test the CAPABLE intervention or compare treatment groups, so it gives no evidence about what therapy or nursing care changes function. Pain, depression, and activity limitation were self-reported, and pain relief was not significantly associated with activity limitation.
Declared interests
The larger CAPABLE study was funded by the Robert Wood Johnson Foundation, the National Institutes of Health, and the Centers for Medicare and Medicaid Services. No separate conflict-of-interest declaration for this secondary analysis is stated.
The easy way to misread this
Do not conclude that treating pain or depression will improve function. These are cross-sectional baseline associations, and the mediation analysis does not show cause or effect.