The aims of this study are: 1) to examine the psychological status in community-dwelling older adults with chronic shoulder pain and compared with age and sex matched healthy controls; and 2) to determine which psychological factors contribute to pain-related disability in community-dwelling older adults.
This is a cross-sectional study. Adults aged above 60 years with or without chronic shoulder pain were recruited in local elderly community centers. We assessed the self-perceived pain-related disability using Shoulder Pain and Disability Index (SPADI); psychological status (depression, anxiety and stress) using Depression, Anxiety and Stress Scales (DASS); and pain beliefs using Pain Catastrophizing Scale.
A total of 77 older adults (50 with chronic shoulder pain and 27 healthy, mean age = 76.0 years) participated in this study. Our results showed older adults with chronic shoulder pain demonstrated significantly higher scores of depression (5.52±7.82 vs. 2.96±5.10, p=0.044), anxiety (5.20±5.50 vs. 2.59±2.98, p=0.013), stress (6.64±7.45 vs. 3.19±4.45, p=0.015) and pain catastrophizing (12.82±12.84 vs. 7.63±9.48, p=0.035) when compared to healthy controls. Pearson correlation analysis showed higher levels of depression (r=0.579, p0.001), anxiety (r=0.547, p0.001), stress (r=0.388, p=0.005) and pain catastrophizing (r=0.535, p0.001) were associated with greater pain-related disability (as measured by SPADI scores) in community-dwelling older adults. Multiple linear regression analysis showed that depression and anxiety are the main contributors to pain-related disability (SPADI scores) (R2=0.395, adjusted R2=0.378, p0.001).
Community-dwelling older adults with chronic shoulder pain demonstrated higher scores of depression, anxiety, stress and pain catastrophizing when compared to healthy participants. Among all these psychological factors, depression and anxiety are the main contributors of pain-related disability in community-dwelling older adults.
Findings from this study suggest the importance of understanding the psychological factors that may be associated with pain-related disability in older adults with chronic shoulder pain. It is essential to increase awareness of prevention, early detection, and proper management of chronic shoulder pain among the elderly in the community. Biopsychosocial interventions and educating older adults with chronic shoulder pain should be considered and warrants further investigation.
psychological factors
pain-related disability
