Association Between Persistent Musculoskeletal Pain and Incident Sarcopenia in China: the Mediating Effect of Depressive Symptoms

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Sep 19

PMID 39296844

Authors

Shengliang Zhou

Yuan Liu

Yan Zhang

Naijia Luo

Quan Chen

Meiling Ge

Bin Shen

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the association between musculoskeletal pain and incident sarcopenia and further explore the mediating effect of depressive symptoms among middle-aged and older Chinese adults.

Methods: Using the data from the China Health and Retirement Longitudinal Study 2011 and 2015, we included 12,788 participants in the cross-sectional analysis and 8,322 for the longitudinal analysis. Musculoskeletal pains located in the neck, back, waist, shoulder, arm, wrist, leg, knee, and ankle were self-reported at baseline and follow-up. The diagnosis criteria of sarcopenia was based on the Asian Working Group for Sarcopenia 2019. Multivariable logistic regression models were used to evaluate the association between musculoskeletal pain, and the Karlson-Holm-Breen (KHB) method was used to explore the mediating effect of depressive symptoms.

Results: Over the 4-year follow-up, 445 participants were identified with incident sarcopenia. In the longitudinal analysis, participants with baseline musculoskeletal pain (adjusted odds ratio (OR): 1.37, 95% confidence interval (CI): 1.07-1.76), persistent musculoskeletal pain (OR:1.68, 95%CI: 1.28-2.24), and persistent waist pain (OR:1.46, 95%CI: 1.04-2.03) were significantly associated with increased the risk of incident sarcopenia. Furthermore, depressive symptoms were found to partially mediate the association between musculoskeletal pain and incident sarcopenia.

Conclusion: Persistent musculoskeletal pain, especially in waist area, was positively associated with a higher risk of sarcopenia among the middle-aged and older Chinese. Depressive symptoms played a partial mediating role in this association.

References

Chen L, Woo J, Assantachai P, Auyeung T, Chou M, Iijima K . Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020; 21(3):300-307.e2. DOI: 10.1016/j.jamda.2019.12.012. View

Lin T, Huang X, Guo D, Zhao Y, Song Q, Liang R . Pain as a risk factor for incident sarcopenia in community-dwelling older adults: A 1-year prospective cohort study. J Am Geriatr Soc. 2022; 71(2):546-552. DOI: 10.1111/jgs.18118. View

Ferreira G, McLachlan A, Lin C, Zadro J, Abdel-Shaheed C, OKeeffe M . Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis. BMJ. 2021; 372:m4825. PMC: 8489297. DOI: 10.1136/bmj.m4825. View

Gerrits M, van Marwijk H, van Oppen P, van der Horst H, Penninx B . Longitudinal association between pain, and depression and anxiety over four years. J Psychosom Res. 2014; 78(1):64-70. DOI: 10.1016/j.jpsychores.2014.10.011. View

Cruz-Jentoft A, Sayer A . Sarcopenia. Lancet. 2019; 393(10191):2636-2646. DOI: 10.1016/S0140-6736(19)31138-9. View

Boshnjaku A . Is age-related sarcopenia a real concern for my developing country?. J Cachexia Sarcopenia Muscle. 2022; 13(6):2589-2592. PMC: 9745483. DOI: 10.1002/jcsm.13107. View

Farrell S, de Zoete R, Cabot P, Sterling M . Systemic inflammatory markers in neck pain: A systematic review with meta-analysis. Eur J Pain. 2020; 24(9):1666-1686. DOI: 10.1002/ejp.1630. View

Wang J, Leung K, Chow S, Cheung W . Inflammation and age-associated skeletal muscle deterioration (sarcopaenia). J Orthop Translat. 2018; 10:94-101. PMC: 5822997. DOI: 10.1016/j.jot.2017.05.006. View

Welsh T, Yang A, Makris U . Musculoskeletal Pain in Older Adults: A Clinical Review. Med Clin North Am. 2020; 104(5):855-872. PMC: 8034863. DOI: 10.1016/j.mcna.2020.05.002. View

10.

Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C . The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014; 73(6):968-74. DOI: 10.1136/annrheumdis-2013-204428. View

11.

Sheffler J, Schmiege S, Sussman J, Bekelman D . A longitudinal analysis of the relationships between depression, fatigue, and pain in patients with heart failure. Aging Ment Health. 2020; 25(12):2272-2278. PMC: 8796211. DOI: 10.1080/13607863.2020.1855626. View

12.

Lohman M, Whiteman K, Greenberg R, Bruce M . Incorporating Persistent Pain in Phenotypic Frailty Measurement and Prediction of Adverse Health Outcomes. J Gerontol A Biol Sci Med Sci. 2017; 72(2):216-222. PMC: 5233918. DOI: 10.1093/gerona/glw212. View

13.

Szlejf C, Suemoto C, Brunoni A, Viana M, Moreno A, Matos S . Depression is Associated With Sarcopenia Due to Low Muscle Strength: Results From the ELSA-Brasil Study. J Am Med Dir Assoc. 2018; 20(12):1641-1646. DOI: 10.1016/j.jamda.2018.09.020. View

14.

Damato T, Christofaro D, Pinheiro M, Morelhao P, Pinto R, de Oliveira Silva D . Does sedentary behaviour contribute to the development of a new episode of low back pain? A systematic review of prospective cohort studies. Eur J Pain. 2022; 26(7):1412-1423. DOI: 10.1002/ejp.1977. View

15.

Liu Y, Wang C, Liu Y . Association between adverse childhood experiences and later-life cardiovascular diseases among middle-aged and older Chinese adults: The mediation effect of depressive symptoms. J Affect Disord. 2022; 319:277-285. DOI: 10.1016/j.jad.2022.09.080. View

16.

Zhong Q, Jiang L, An K, Zhang L, Li S, An Z . Depression and risk of sarcopenia: a national cohort and Mendelian randomization study. Front Psychiatry. 2023; 14:1263553. PMC: 10618558. DOI: 10.3389/fpsyt.2023.1263553. View

17.

Liu Y, Cui J, Cao L, Stubbendorff A, Zhang S . Association of depression with incident sarcopenia and modified effect from healthy lifestyle: The first longitudinal evidence from the CHARLS. J Affect Disord. 2023; 344:373-379. DOI: 10.1016/j.jad.2023.10.012. View

18.

Hu Y, Peng W, Ren R, Wang Y, Wang G . Sarcopenia and mild cognitive impairment among elderly adults: The first longitudinal evidence from CHARLS. J Cachexia Sarcopenia Muscle. 2022; 13(6):2944-2952. PMC: 9745544. DOI: 10.1002/jcsm.13081. View

19.

Teichtahl A, Urquhart D, Wang Y, Wluka A, Wijethilake P, OSullivan R . Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults. Spine J. 2015; 15(7):1593-601. DOI: 10.1016/j.spinee.2015.03.039. View

20.

Sayer A, Cruz-Jentoft A . Sarcopenia definition, diagnosis and treatment: consensus is growing. Age Ageing. 2022; 51(10). PMC: 9588427. DOI: 10.1093/ageing/afac220. View