• Elisa J de Koning, Erik J Timmermans, Natasja M van Schoor, Brendon Stubbs, Tessa N van den Kommer, Elaine M Dennison, Federica Limongi, Maria Victoria Castell, Mark H Edwards, Rocio Queipo, Cyrus Cooper, Paola Siviero, Suzan van der Pas, Nancy L Pedersen, Mercedes Sánchez-Martínez, DeegDorly J HDJHDepartment of Epidemiology and Biostatistics / Amsterdam Public Health Research Institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands., Michael D Denkinger, and EPOSA Group.
• Department of Epidemiology and Biostatistics / Amsterdam Public Health Research Institute, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. Electronic address: ej.dekoning@vumc.nl.
• J Pain. 2018 Jun 1; 19 (6): 690-698.

AbstractPain is a key symptom of osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of pain severity as well as within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1-85 years). Moreover, older-old participants experienced fewer symptoms of anxiety (ratio = .85, 95% confidence interval [CI], .77-.94), depression (ratio = .90, 95% CI, .82-.98), and total affective symptoms (ratio = .87, 95% CI, .79-.94) if their pain fluctuated more. No such association was evident in younger-old participants (65-74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons.Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

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