Predictors of Mental Health Status among Older United States Adults with Pain

Abstract

Poor mental health is common among older adults with pain, resulting in high economic burden and impaired quality of life. This retrospective, cross-sectional database study aimed to identify characteristics associated with good mental health status among United States (US) adults aged ≥50 years with self-reported pain in the last four weeks using a weighted sample of 2017 Medical Expenditure Panel Survey data. Hierarchical multivariable logistic regression models were used to identify statistically significant predictors of good (versus poor) perceived mental health status. From a weighted population of 57,074,842 individuals, 85.5% (95% confidence interval (CI) = 84.4%, 86.7%) had good perceived mental health. Good mental health was associated most strongly with physical health status (adjusted odds ratio (AOR) = 9.216, 95% CI = 7.044, 12.058). Employed individuals were 1.7 times more likely to report good mental health versus unemployed (AOR = 1.715, 95% CI = 1.199, 2.452). Individuals who had completed less than high school education (AOR = 0.750, 95% CI = 0.569, 0.987) or who reported having a limitation (AOR = 0.513, 95% CI = 0.384, 0.684) were less likely to report good mental health. These key characteristics can be utilized to predict mental health status, which may be investigated to better manage concurrent pain and poor mental health.

Relationship between Perceived Pain Interference and Poor Psychological Wellbeing among United States Adults

“…Although many studies have looked at specific types of pain and psychological wellbeing, this study reports that any pain correlates with deficits in mental flexibility which may affect the psychological wellbeing of an individual. Meanwhile, a report using 2017 MEPS data looking at psychological wellbeing in older US adults with pain found that overall health status to be the greatest predictor of psychological wellbeing [ 13 ]. Physical health can have direct and indirect effects on functioning which impact psychological wellbeing such as restrictions to exercise and quality of life.…”

“…Next, our study found that good overall health status was associated with lower odds of reporting poor psychological wellbeing. Good health status was also found to be the strongest predictor of good psychological wellbeing among older US adults in a further study [ 13 ]. This finding aligns with a previous mediation analysis study that found strong indirect effects between mental and physical health [ 38 ].…”

“…Studies have also reported that addressing poor psychological wellbeing may be a significant approach for pain management due to its complex psychosocial aspects [ 12 ]. Although there is literature on the relationship and healthcare costs of pain and psychological wellbeing in older US adults [ 13 , 14 ], there are limited studies on the relationship among perceived pain interference and psychological wellbeing in US adults regardless of age. The primary objective of this project was to assess the association among perceived pain interference and poor psychological wellbeing in US adults.…”

Health-related quality of life in older women with injuries: a nationwide study

“…Participation in economic activities may be the most influential factor in improving the quality of life of older adults. It provides a space for social participation, fulfills basic living needs, assists people in recovering from their sense of loss of a role relating to a job, and increases physical and mental satisfaction ( 29 ). Job-related activity assists older adults in recovering their health and extending their life expectancies beyond various chronic diseases they suffer from Kwak and Kim ( 28 ).…”

Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study

“…It was interesting that perceived mental health condition was not associated with reporting a functional limitation; previous research also using MEPS data found that having any type of limitation was associated with lower likelihood of an individual reporting good mental health (AOR = 0.51, 95% CI = 0.38, 0.68) [ 33 ]. Thus, further research into the association between types of limitations and mental health status may be warranted.…”