Functional disability mediates the relationship between pain and depression among community-dwelling older adults: Age and sex as moderators

Objective: To examine the moderating effects of age and sex in the role of functional disability as a mediator between pain and depression. Methods: Participants were 1917 community-dwelling older adults from Jinan, China. Data were collected on pain intensity, functional disability in activities of daily living and instrumental activities of daily living, depressive symptoms and covariates. Results: Functional disability partially mediated the relationship between pain intensity and depressive symptoms (estimate = 0.015, SE = 0.007, 95% CI [0.004, 0.030]). Age and sex moderated both the direct and indirect effect of the mediation model. The mediating effect of functional disability was significant in the old old men, young-old men, and young-old women, but not in the old-old women. Conclusions: Interventions should target both pain and pain-related functional disability to improve their emotional well-being among community-dwelling older adults. Importantly, strategies should be tailored across different age and sex groups to improve their effectiveness. (c) 2020 Elsevier Inc. All rights reserved.