Background
Methods
Study sample
Outcomes
Covariates
Statistical analysis
Having no “lifetime” history of depression | Having a “lifetime” history of subthreshold depressive symptoms | Having a “lifetime” history of depression | Having present depression | Total | |
---|---|---|---|---|---|
Participants | 11,137 (45.6) | 5317 (21.8) | 7951 (32.6) | 912 (3.7) | 24,405 (100.0) |
Demographic characteristics | |||||
Age, mean (SD) | 65.3 (7.3) | 64.3 (7.5) | 62.5 (7.3) | 59.6 (7.0) | 64.1 (7.5) |
Gender: male | 5036 (45.2) | 1963 (36.9) | 2229 (28.0) | 295 (32.3) | 9228 (37.8) |
Ethnicity | |||||
White | 10,825 (97.2) | 5151 (96.9) | 7730 (97.2) | 877 (96.2) | 23,706 (97.1) |
Black | 69 (0.6) | 37 (0.7) | 44 (0.6) | 9 (1.0) | 150 (0.6) |
Asian | 72 (0.6) | 42 (0.8) | 44 (0.6) | 5 (0.5) | 158 (0.6) |
Chinese | 23 (0.2) | 6 (0.1) | 14 (0.2) | 1 (0.1) | 43 (0.2) |
Mixed | 43 (0.4) | 27 (0.5) | 44 (0.6) | 4 (0.4) | 114 (0.5) |
Other | 51 (0.5) | 29 (0.5) | 39 (0.5) | 9 (1.0) | 119 (0.5) |
Missing | 54 (0.5) | 25 (0.5) | 36 (0.5) | 7 (0.8) | 115 (0.5) |
Townsend deprivation score | |||||
Most | 1192 (10.7) | 796 (15.0) | 1285 (16.2) | 244 (26.8) | 3273 (13.4) |
Average | 3310 (29.7) | 1765 (33.2) | 2692 (33.9) | 331 (36.3) | 7767 (31.8) |
Least | 6622 (59.5) | 2750 (51.7) | 3959 (49.8) | 333 (36.5) | 13,331 (54.6) |
Missing | 13 (0.1) | 6 (0.1) | 15 (0.2) | 4 (0.4) | 34 (0.1) |
BMI | |||||
Obesity | 2257 (20.3) | 1422 (26.7) | 2295 (28.9) | 411 (45.1) | 5974 (24.5) |
Overweight | 4617 (41.5) | 2076 (39.0) | 2954 (37.2) | 280 (30.7) | 9647 (39.5) |
Underweight or normal | 4219 (37.9) | 1800 (33.9) | 2674 (33.6) | 214 (23.5) | 8693 (35.6) |
Missing | 44 (0.4) | 19 (0.4) | 28 (0.4) | 7 (0.8) | 91 (0.4) |
Lifestyle behaviors | |||||
Smoking status | |||||
Current | 616 (5.5) | 450 (8.5) | 786 (9.9) | 154 (16.9) | 1852 (7.6) |
Former | 4016 (36.1) | 2033 (38.2) | 3088 (38.8) | 326 (35.7) | 9137 (37.4) |
Never | 6475 (58.1) | 2820 (53.0) | 4053 (51.0) | 426 (46.7) | 13,348 (54.7) |
Missing | 30 (0.3) | 14 (0.3) | 24 (0.3) | 6 (0.7) | 68 (0.3) |
Heavy drinkers | 795 (7.1) | 395 (7.4) | 533 (6.7) | 80 (8.8) | 1723 (7.1) |
Physical activity | |||||
High | 3655 (32.8) | 1582 (29.8) | 2426 (30.5) | 251 (27.5) | 7663 (31.4) |
Moderate | 3996 (35.9) | 1810 (34.0) | 2813 (35.4) | 263 (28.8) | 8619 (35.3) |
Low | 1705 (15.3) | 941 (17.7) | 1457 (18.3) | 234 (25.7) | 4103 (16.8) |
Missing | 1781 (16.0) | 984 (18.5) | 1255 (15.8) | 164 (18.0) | 4020 (16.5) |
Comorbidities | |||||
Stroke | 161 (1.4) | 87 (1.6) | 108 (1.4) | 13 (1.4) | 356 (1.5) |
Coronary artery disease | 983 (8.8) | 557 (10.5) | 750 (9.4) | 119 (13.0) | 2290 (9.4) |
Heart failure | 75 (0.7) | 58 (1.1) | 42 (0.5) | 9 (1.0) | 175 (0.7) |
Peripheral artery disease | 293 (2.6) | 184 (3.5) | 258 (3.2) | 57 (6.3) | 735 (3.0) |
Diabetes | 524 (4.7) | 436 (8.2) | 590 (7.4) | 145 (15.9) | 1550 (6.4) |
Addison’s disease | 4 (0.0) | 9 (0.2) | 6 (0.1) | 1 (0.1) | 19 (0.1) |
Cystic fibrosis | 3 (0.0) | 0 (0.0) | 2 (0.0) | 1 (0.1) | 5 (0.0) |
COPD | 342 (3.1) | 248 (4.7) | 383 (4.8) | 75 (8.2) | 973 (4.0) |
Asthma | 934 (8.4) | 647 (12.2) | 1197 (15.1) | 189 (20.7) | 2778 (11.4) |
Parkinson’s disease | 23 (0.2) | 29 (0.5) | 23 (0.3) | 2 (0.2) | 75 (0.3) |
Epilepsy | 92 (0.8) | 73 (1.4) | 107 (1.3) | 25 (2.7) | 272 (1.1) |
Multiple sclerosis | 62 (0.6) | 50 (0.9) | 74 (0.9) | 15 (1.6) | 186 (0.8) |
Paralysis | 84 (0.8) | 52 (1.0) | 77 (1.0) | 16 (1.8) | 213 (0.9) |
Solid organ cancers | 1141 (10.2) | 558 (10.5) | 777 (9.8) | 85 (9.3) | 2476 (10.1) |
Hematological cancers | 134 (1.2) | 71 (1.3) | 86 (1.1) | 14 (1.5) | 291 (1.2) |
Metastatic cancers | 245 (2.2) | 129 (2.4) | 175 (2.2) | 19 (2.1) | 549 (2.2) |
Dementia | 10 (0.1) | 18 (0.3) | 16 (0.2) | 2 (0.2) | 44 (0.2) |
Schizophrenia | 2 (0.0) | 4 (0.1) | 9 (0.1) | 4 (0.4) | 15 (0.1) |
Connective tissue disease | 188 (1.7) | 135 (2.5) | 203 (2.6) | 36 (3.9) | 526 (2.2) |
Chronic liver disease | 229 (2.1) | 155 (2.9) | 259 (3.3) | 58 (6.4) | 643 (2.6) |
Inflammatory bowel disease | 211 (1.9) | 137 (2.6) | 185 (2.3) | 20 (2.2) | 533 (2.2) |
Chronic kidney disease | 306 (2.7) | 214 (4.0) | 259 (3.3) | 39 (4.3) | 779 (3.2) |
End-stage kidney disease | 7 (0.1) | 5 (0.1) | 2 (0.0) | 0 (0) | 14 (0.1) |
HIV/AIDS | 1 (0.0) | 6 (0.1) | 14 (0.2) | 5 (0.5) | 21 (0.1) |
Regular opioid use | 744 (6.7) | 624 (11.7) | 1106 (13.9) | 221 (24.2) | 2575 (10.1) |
Results
Primary outcome
Chronic widespread pain | Chronic regional pain | |||
---|---|---|---|---|
Having a “lifetime” history of depression | Having present depression | Having a “lifetime” history of depression | Having present depression | |
Overall | 45.7%, 1716/3757 | 10.5%, 396/3757 | 30.2%, 6235/20,648 | 2.5%, 516/20,648 |
Demographic characteristics | ||||
Age | ||||
45 to 54 | 61.4%, 333/542 | 22.3%, 121/542 | 38.4%, 1047/2729 | 4.8%, 132/2729 |
55 to 64 | 54.4%, 724/1331 | 14.0%, 186/1331 | 35.9%, 2531/7050 | 3.3%, 234/7050 |
65 or more | 35.0%, 659/1884 | 4.7%, 89/1884 | 24.4%, 2657/10,869 | 1.4%, 150/10,869 |
Gender | ||||
Male | 35.9%, 350/975 | 10.3%, 100/975 | 22.8%, 1879/8253 | 2.4%, 195/8253 |
Female | 49.1%, 1366/2782 | 10.6%, 296/2782 | 35.1%, 4356/12,395 | 2.6%, 321/12,395 |
Ethnicity | ||||
White | 45.7%, 1637/3585 | 10.5%, 377/3585 | 30.3%, 6093/20,121 | 2.5%, 500/20,121 |
Non-white | 45.4%, 54/119 | 10.1%, 12/119 | 26.6%, 92/346 | 2.0%, 7/346 |
Townsend deprivation score | ||||
Most | 51.6%, 363/703 | 16.9%, 119/703 | 35.9%, 922/2570 | 4.9%, 125/2570 |
Average | 48.4%, 645/1334 | 12.1%, 161/1334 | 31.8%, 2047/6433 | 2.6%, 170/6433 |
Least | 41.2%, 705/1713 | 6.8%, 116/1713 | 28.0%, 3254/11,618 | 1.9%, 217/11,618 |
BMI | ||||
Obesity | 50.6%, 713/1409 | 14.3%, 201/1409 | 34.7%, 1582/4565 | 4.6%, 210/4565 |
Overweight | 43.4%, 603/1388 | 8.9%, 124/1388 | 28.5%, 2351/8259 | 1.9%, 156/8259 |
Underweight or normal | 41.5%, 390/939 | 7.2%, 68/939 | 29.5%, 2284/7754 | 1.9%, 146/7754 |
Lifestyle behaviors | ||||
Smoking status | ||||
Current | 55.8%, 198/355 | 20.8%, 74/355 | 39.3%, 588/1497 | 5.3%, 80/1497 |
Former | 45.5%, 663/1458 | 10.3%, 150/1458 | 31.6%, 2425/7679 | 2.3%, 176/7679 |
Never | 43.9%, 847/1930 | 8.8%, 169/1930 | 28.1%, 3206/11,418 | 2.3%, 257/11,418 |
Alcohol consumption | ||||
Heavy drinker | 44.9%, 89/198 | 12.1%, 24/198 | 29.1%, 444/1525 | 3.7%, 56/1525 |
Not heavy drinker | 45.7%, 1627/3559 | 10.5%, 372/3559 | 30.3%, 5791/19,123 | 2.4%, 460/19,123 |
Physical activity | ||||
High | 43.0%, 472/1097 | 9.0%, 99/1097 | 29.8%, 1954/6566 | 2.3%, 152/6566 |
Moderate | 46.6%, 542/1162 | 8.9%, 103/1162 | 30.5%, 2271/7457 | 2.1%, 160/7457 |
Low | 51.9%, 375/723 | 14.7%, 106/723 | 32.0%, 1082/3380 | 3.8%, 128/3380 |
Comorbidities | ||||
Stroke | ||||
Yes | 46.0%, 39/63 | 9.5%, 6/63 | 27.0%, 79/293 | 2.4%, 7/293 |
No | 45.7%, 1687/3694 | 10.6%, 390/3694 | 30.2%, 6156/20,355 | 2.5%, 509/20,355 |
Coronary artery disease | ||||
Yes | 42.3%, 218/515 | 11.3%, 58/515 | 30.0%, 532/1775 | 3.4%, 61/1775 |
No | 46.2%, 1498/3242 | 10.4%, 338/3242 | 30.2%, 5703/18,873 | 2.4%, 455/18,873 |
Heart failure | ||||
Yes | 25.0%, 11/44 | 4.5%, 2/44 | 23.7%, 31/131 | 5.3%, 7/131 |
No | 45.9%, 1705/3713 | 10.6%, 394/3713 | 30.2%, 6204/20,517 | 2.5%, 509/20,517 |
Peripheral artery disease | ||||
Yes | 50.6%, 90/178 | 17.4%, 31/178 | 30.2%, 168/557 | 4.7%, 26/557 |
No | 45.4%, 1626/3579 | 10.2%, 365/3579 | 30.2%, 6067/20,091 | 2.4%, 490/20,091 |
Diabetes | ||||
Yes | 50.2%, 227/452 | 17.7%, 80/452 | 33.1%, 363/1098 | 5.9%, 65/1098 |
No | 45.1%, 1489/3305 | 9.6%, 316/3305 | 30.0%, 5872/19,550 | 2.3%, 451/19,550 |
Addison’s disease | ||||
Yes | 60.0%, 3/5 | - | 21.4%, 3/14 | 7.1%, 1/14 |
No | 45.7%, 1713/3752 | 10.6%, 396/3752 | 30.2%, 6232/20,634 | 2.5%, 515/20,634 |
Cystic fibrosis | ||||
Yes | 33.3%, 1/3 | 33.3%, 1/3 | 50.0%, 1/2 | - |
No | 45.7%, 1715/3754 | 10.5%, 395/3754 | 30.2%, 6234/20,646 | 2.5%, 516/20,646 |
Chronic obstructive pulmonary disease | ||||
Yes | 45.5%, 138/303 | 12.9%, 39/303 | 36.6%, 245/670 | 5.4%, 36/670 |
No | 45.7%, 1578/3454 | 10.3%, 357/3454 | 30.0%, 5990/19,978 | 2.4%, 480/19,978 |
Asthma | ||||
Yes | 53.5%, 386/722 | 15.1%, 109/722 | 39.4%, 811/2056 | 3.9%, 80/2056 |
No | 43.8%, 1330/3035 | 9.5%, 287/3035 | 29.2%, 5424/18,592 | 2.3%, 436/18,592 |
Parkinson’s disease | ||||
Yes | 44.4%, 8/18 | - | 26.3%, 15/57 | 3.5%, 2/57 |
No | 45.7%, 1708/3739 | 10.6%, 396/3343 | 30.2%, 6220/20,591 | 2.5%, 514/20,591 |
Epilepsy | ||||
Yes | 54.5%, 36/66 | 21.2%, 14/66 | 34.5%, 71/206 | 5.3%, 11/206 |
No | 45.5%, 1680/3691 | 10.3%, 382/3691 | 30.2%, 6164/20,442 | 2.5%, 505/20,442 |
Multiple sclerosis | ||||
Yes | 49.3%, 35/59 | 22.0%, 13/59 | 30.7%, 39/127 | 1.6%, 2/127 |
No | 45.5%, 1681/3698 | 10.4%, 383/3315 | 30.2%, 6196/20,521 | 2.5%, 514/20,521 |
Paralysis | ||||
Yes | 55.7%, 34/61 | 16.4%, 10/61 | 28.3%, 43/152 | 3.9%, 6/152 |
No | 45.5%, 1682/3696 | 10.4%, 386/3696 | 30.2%, 6192/20,496 | 2.5%, 510/20,496 |
Solid organ cancers | ||||
Yes | 43.7%, 184/421 | 9.3%, 39/421 | 28.9%, 593/2055 | 2.2%, 46/2055 |
No | 45.9%, 1532/3336 | 10.7%, 357/3336 | 30.3%, 5642/18,593 | 2.5%, 470/18,593 |
Hematological cancers | ||||
Yes | 38.5%, 20/52 | 9.6%, 5/52 | 27.6%, 66/239 | 3.8%, 9/239 |
No | 45.8%, 1696/3705 | 10.6%, 391/3705 | 30.2%, 6169/20409 | 2.5%, 507/20409 |
Metastatic cancers | ||||
Yes | 43.6%, 41/94 | 8.5%, 8/94 | 29.5%, 134/455 | 2.4%, 11/455 |
No | 45.7%, 1675/3663 | 10.6%, 388/3663 | 30.2%, 6101/20,193 | 2.5%, 505/20,193 |
Dementia | ||||
Yes | 44.4%, 8/18 | 5.6%, 1/18 | 30.8%, 8/26 | 3.8%, 1/26 |
No | 45.7%, 1708/3739 | 10.6%, 395/3739 | 30.2%, 6227/20,622 | 2.5%, 515/20,622 |
Schizophrenia | ||||
Yes | - | - | 60.0%, 9/15 | 26.7%, 4/15 |
No | 45.7%, 1716/3757 | 10.5%, 396/3757 | 30.2%, 6226/20,633 | 2.5%, 512/20,633 |
Connective tissue disease | ||||
Yes | 42.9%, 93/217 | 11.5%, 25/217 | 35.6%, 110/309 | 3.6%, 11/309 |
No | 45.8%, 1623/3540 | 10.5%, 371/3540 | 30.1%, 6125/20,339 | 2.5%, 505/20,339 |
Chronic liver disease | ||||
Yes | 53.5%, 108/202 | 16.8%, 34/202 | 34.2%, 151/441 | 5.4%, 24/441 |
No | 45.2%, 1608/3555 | 10.2%, 362/3555 | 30.1%, 6084/20,207 | 2.4%, 492/20,207 |
Inflammatory bowel disease | ||||
Yes | 46.7%, 57/122 | 7.4%, 9/122 | 31.1%, 128/411 | 2.7%, 11/411 |
No | 45.6%, 1659/3635 | 10.6%, 387/3635 | 30.2%, 6107/20,237 | 2.5%, 505/20,237 |
Chronic kidney disease | ||||
Yes | 38.0%, 78/205 | 6.3%, 13/205 | 31.5%, 181/574 | 4.5%, 26/574 |
No | 46.1%, 1638/3552 | 10.8%, 383/3552 | 30.2%, 6054/20,074 | 2.4%, 490/20,074 |
End-stage kidney disease | ||||
Yes | 66.7%, 4/6 | - | 25.0%, 2/8 | - |
No | 45.7%, 1716/3751 | 10.6%, 396/3751 | 30.2%, 6233/20,640 | 2.5%, 516/20,640 |
HIV/AIDS | ||||
Yes | 50.0%, 2/4 | 25.0%, 1/4 | 70.6%, 12/17 | 23.5%, 4/17 |
No | 45.7%, 1714/3753 | 10.5%, 395/3753 | 30.2%, 6223/20,631 | 2.5%, 512/20,631 |
Regular opioid use | ||||
Yes | 50.2%, 461/919 | 13.8%, 127/919 | 41.5%, 645/1555 | 6.0%, 94/1555 |
No | 44.2%, 1255/2838 | 9.5%, 269/2838 | 29.3%, 5590/19,093 | 2.2%, 422/19,093 |
Nature of pain | ||||
Neuropathic pain | - | - | 38.3%, 1582/4135 | 4.3%, 178/4135 |
Non-neuropathic pain | - | - | 28.2%, 4653/16,513 | 2.0%, 338/16,513 |
Pain location that bothers you most | ||||
Leg pain | - | - | 31.4%, 285/907 | 2.6%, 24/907 |
Chest pain | - | - | 36.0%, 81/225 | 6.2%, 14/225 |
Feet pain | - | - | 29.7%, 483/1629 | 2.6%, 42/1629 |
Hand pain | - | - | 31.7%, 451/1421 | 1.9%, 27/1421 |
Arm pain | - | - | 30.7%, 108/352 | 2.6%, 9/352 |
Knee pain | - | - | 28.4%, 784/2765 | 2.1%, 58/2765 |
Hip pain | - | - | 31.8%, 473/1487 | 2.4%, 36/1487 |
Stomach or abdominal pain | - | - | 37.4%, 293/784 | 3.8%, 30/784 |
Back pain | - | - | 30.2%, 1376/4552 | 3.1%, 141/4552 |
Neck or shoulder pain | - | - | 33.7%, 863/2562 | 2.5%, 63/2562 |
Facial pain | - | - | 36.0%, 71/197 | 2.5%, 5/197 |
Headache | - | - | 38.7%, 402/1040 | 3.8%, 39/1040 |