Depressive symptoms scores are positively associated with incident spinal pain risk in middle-aged and elderly populations
A prospective cohort study using 9-year CHARLS data found that each 1-point increase in depressive symptoms score (CESD-10) was associated with an 8% higher risk of incident spinal pain (OR=1.08, 95% CI:1.05-1.11). The highest quartile had a 2.58-fold higher risk compared to the lowest, with a linear dose-response relationship and a critical threshold of approximately 2.1.
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Depressive symptoms scores are positively associated with incident spinal pain risk in middle-aged and elderly populations The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Depressive symptoms scores are positively associated with incident spinal pain risk in middle-aged and elderly populations
This conclusion is most relevant to: 3934 middle-aged and elderly Chinese adults (≥45 years, no baseline spinal pain) from the China Health and Retirement Longitudinal Study (CHARLS).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Depressive symptoms score and risk of incident spinal pain in middle-aged and elderly populations: a prospective cohort study based on china health and retirement longitudinal study data. (European journal of physical and rehabilitation medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Depressive symptoms lower pain thresholds through central sensitization
- ▸Chronic pain induces neuroendocrine and immune dysfunctions
- ▸Negative coping behaviors exacerbate pain perception
- ▸Result: Increased risk of incident spinal pain
Who Might Benefit
Evidence fit by population:
- ▸3934 middle-aged and elderly Chinese adults (≥45 years, no baseline spinal pain) from the China Health and Retirement Longitudinal Study (CHARLS)
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Observational design cannot establish definitive causality
- ▸Potential residual confounding from unmeasured variables (e.g., physical activity, medication use)
- ▸Reliance on self-reported spinal pain may introduce misclassification bias
Frequently Asked Questions
What is the critical threshold for depressive symptoms score that increases spinal pain risk?▼
The critical threshold was approximately 2.1 on the CESD-10 scale, above which the risk of incident spinal pain significantly increases.
Does dyslipidemia modify the association between depressive symptoms and spinal pain?▼
Yes, dyslipidemia had a significant moderating effect (P=0.006), with a weaker association in those with dyslipidemia, but no significant mediation effect was found.
How large was the sample size and follow-up duration?▼
The study included 3934 participants followed for 9 years (2011-2020), with 223 incident cases of spinal pain.
What population was studied and were there sex differences?▼
The study focused on middle-aged and elderly Chinese adults (≥45 years), with 52.41% males and 47.59% females; those with incident spinal pain were more likely to be female.
References
- 1.Yuan Y, Yu X, Li Z, Yuan S, Zhu A, Huang H, Liu S. “Depressive symptoms score and risk of incident spinal pain in middle-aged and elderly populations: a prospective cohort study based on china health and retirement longitudinal study data..” European journal of physical and rehabilitation medicine, 2026. PMID: 42517168 DOI: 10.23736/S1973-9087.26.09409-8