Abstract
BACKGROUND: This study aims to analyze the association between different pain phenotypes and depressive symptom trajectory among community-dwelling older adults, and whether and how providing caregiving render older adults with pain more prone to a deteriorating depressive trajectory. METHODS: Data were derived from the Health and Retirement Study between 2008 and 2020. Older adults were classified into different pain phenotypes leveraging four pain characteristics at baseline (i.e. 2008) using latent class analysis, including pain intensity, pain interference, pain location, and pain persistence. Caregiving status was collected at baseline using helper lists. Depressive symptoms were measured biennially from 2008 to 2020. Linear mixed models were constructed to explore the independent and interacted effects of pain phenotypes and providing caregiving on depressive symptom trajectory. RESULTS: Among 8486 participants aged 60 years old or over (58.8% females, and mean age of 74.28), four pain phenotypes were identified: Severe-persistent pain group (15.0%), Moderate pain group (17.3%), Back pain group (7.0%), and Pain-free group (60.7%). Compared to the Pain-free group, other three pain subtypes exhibited higher baseline depression symptoms with a gradient trend. Older adults with Severe-persistent pain had a significantly slower rate of depression symptom increase. Caregiving did not moderate the impact of any pain subtype on baseline depression symptoms, but it significantly reduced the rate of increase in depression symptoms for both Severe-persistent pain group and Back pain group. CONCLUSIONS: Pain phenotype-informed depression services should be delivered. Promoting the caregiving benefit finding for the elderly would contribute to the remission of depressive symptom.