Pain and Depression in Late Life: Mastery as Mediator and Moderator

Objectives. This study examines how mastery mediates and moderates the relationship between pain and depression among older adults, as well as the extent to which these processes differ by the timing of pain in late life, while utilizing statistical methods that comprehensively control for time-stable confounds. Methods. Data are derived from multiple observations of adults aged 65 years and older in the Washington, DC, metropolitan area over a 4-year period. Fixed effects models are used to control for time-stable influences. Results. With all time-stable influences controlled, pain is positively related to symptoms of depression, although this relationship is substantially reduced in comparison with a model in which all time-stable confounds are not held constant. Mastery does not mediate this relationship because pain is not significantly related to mastery once time-stable factors are taken into account. Mastery buffers the relationship between pain and depression, but only for elders later in late life. Discussion. This study suggests that a synthesis of stress process and life course perspectives is critical for understanding how pain influences depression in late life. However, research that does not comprehensively control for time-stable factors may overestimate the consequences of pain for older adults.