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已发表论文
抑郁作为疼痛发病的独立预测因素：来自中国健康与养老追踪调查（CHARLS）的纵向证据
Authors Song W, Wang S , Cao Z, Lin J
Received 6 July 2025
Accepted for publication 9 October 2025
Published 17 October 2025 Volume 2025:18 Pages 5481—5491
DOI https://doi.org/10.2147/JPR.S551970
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Jonathan Greenberg
Wenwen Song,1,2 Shenghan Wang,1,2 Zhijian Cao,1,2 Jiangnan Lin1,2
1Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, People’s Republic of China; 2The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
Correspondence: Jiangnan Lin, Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, People’s Republic of China, Email linjiangnan@zcmu.edu.cn
Background: This study employs a longitudinal research design to investigate the impact of depression as an independent risk factor on the incidence of pain among middle-aged and elderly populations, with the objective of providing evidence for early intervention strategies to reduce pain-related disability and improve quality of life in aging populations.
Methods: This study utilized baseline data from the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS). Participants aged ≥ 45 years without baseline pain were included (n = 4,966), with three follow-up assessments conducted in 2013, 2015, and 2018. Pain occurrence was defined as the first self-reported pain episode during follow-up. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) (score ≥ 10). Multivariable Cox regression was used to assess the impact of depression and various demographic factors on pain occurrence, and stratified analysis was conducted to further clarify the independence of depression as a risk factor.
Results: Among 4,966 participants, depressive symptoms were significantly associated with higher pain incidence (HR = 1.35, 95% CI: 1.25– 1.47). Other predictors included female sex (HR = 1.55), arthritis (HR = 1.61), Activities of Daily Living/ Instrumental Activities of Daily Living (ADL/IADL) dysfunction (HR = 1.23), and chronic diseases (lung/kidney/digestive). Subgroup analyses identified a significant ADL/IADL-pain interaction (P = 0.001), with no other depression-related interactions observed.
Conclusion: Depression serves as an independent predictor of pain onset among middle-aged and elderly populations in China, and this relationship is further complicated by functional decline. Early screening for depressive symptoms and functional decline may help alleviate pain-related disability in elderly populations. Future research should investigate the dynamic relationship between pain and depression across different disease subtypes and treatment contexts.
Keywords: depression, pain, middle-aged and elderly, risk factors, CHARLS
1Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, People’s Republic of China; 2The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
Correspondence: Jiangnan Lin, Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, People’s Republic of China, Email linjiangnan@zcmu.edu.cn
Background: This study employs a longitudinal research design to investigate the impact of depression as an independent risk factor on the incidence of pain among middle-aged and elderly populations, with the objective of providing evidence for early intervention strategies to reduce pain-related disability and improve quality of life in aging populations.
Methods: This study utilized baseline data from the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS). Participants aged ≥ 45 years without baseline pain were included (n = 4,966), with three follow-up assessments conducted in 2013, 2015, and 2018. Pain occurrence was defined as the first self-reported pain episode during follow-up. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) (score ≥ 10). Multivariable Cox regression was used to assess the impact of depression and various demographic factors on pain occurrence, and stratified analysis was conducted to further clarify the independence of depression as a risk factor.
Results: Among 4,966 participants, depressive symptoms were significantly associated with higher pain incidence (HR = 1.35, 95% CI: 1.25– 1.47). Other predictors included female sex (HR = 1.55), arthritis (HR = 1.61), Activities of Daily Living/ Instrumental Activities of Daily Living (ADL/IADL) dysfunction (HR = 1.23), and chronic diseases (lung/kidney/digestive). Subgroup analyses identified a significant ADL/IADL-pain interaction (P = 0.001), with no other depression-related interactions observed.
Conclusion: Depression serves as an independent predictor of pain onset among middle-aged and elderly populations in China, and this relationship is further complicated by functional decline. Early screening for depressive symptoms and functional decline may help alleviate pain-related disability in elderly populations. Future research should investigate the dynamic relationship between pain and depression across different disease subtypes and treatment contexts.
Keywords: depression, pain, middle-aged and elderly, risk factors, CHARLS