A new study from University College London (UCL) has found that middle-aged and older adults who experience moderate to severe pain are more likely to have experienced worsening depression for up to eight years before the pain began.
The findings, published in the journal eClinicalMedicine, suggest that early treatment for depression could help prevent or lessen future aches and pains.
The study involved 3,668 adults over the age of 50 who reported experiencing moderate to severe pain. These participants were compared to a matched group of the same number who did not report significant pain.
The data showed that depressive symptoms worsened in the eight years leading up to the onset of pain, peaked around the time pain started, and stayed high afterward. In contrast, those without pain had fewer and more stable depressive symptoms over time.
A similar pattern was seen for loneliness. People who experienced pain also reported increasing feelings of loneliness both before and after the pain began. In the group without pain, loneliness levels remained low and stable. Most of the people in the pain group reported discomfort in their back, knees, hips, or feet.
Dr. Mikaela Bloomberg, lead author of the study, explained that depression and pain are closely linked, often making each other worse.
She said their study is the first to show that symptoms of depression and loneliness increase years before the pain begins. This suggests that addressing mental health issues early may help delay or prevent chronic pain later in life.
The study points to several ways in which mental health issues may contribute to pain. Stress from depression and loneliness can increase inflammation in the body and make people more sensitive to pain. It can also affect how the immune system works and disrupt the nervous system’s normal functions, making it harder for the body to regulate pain.
The researchers used 21 years of data from the English Longitudinal Study of Ageing (ELSA), a national study that surveys older adults in England every two years.
They also found that the rise in depression was more pronounced in people with lower education and income levels, likely because these individuals had fewer resources to manage their health and mental well-being.
Interestingly, the researchers found that social isolation—defined as the number of contacts with friends and family—did not differ much between those with and without pain.
This means that how lonely someone feels may be more important than how often they see other people. The study suggests that the quality of relationships, not just the number, plays a key role in protecting against pain and depression.
Among those in the pain group, 75% reported pain in their back, knees, hips, or feet. Other areas included full-body pain (1.9%), mouth or tooth pain (0.5%), and various other locations (20.7%).
The researchers noted that most participants were white, reflecting the demographic of older adults in England. They hope future research will include younger and more diverse groups. Although the data did not clearly separate short-term pain from chronic pain, results remained consistent even when only long-term pain was considered.
The team carefully adjusted their results for other possible factors such as age, sex, education, wealth, physical activity, smoking, alcohol use, and pre-existing health conditions.
This study was funded by the Nuffield Foundation’s Oliver Bird Fund and Versus Arthritis. The English Longitudinal Study of Ageing is supported by the National Institute on Aging and several UK government departments.
If you care about mental health, please read studies about Cannabis use disorder linked to increased risk of these mental diseases and findings of Some mental health drugs can cause rapid weight gain.
For more about mental health, please read studies about One sleepless night can reverse depression for days and findings of Scientists find better treatment for older adults with depression.
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