Depressive Symptoms and Physical Activity Mediate the Adverse Effect of Pain on Functional Dependence in Patients With Arthritis: Evidence From the Canadian Longitudinal Study on Aging
Bibliographic record
Abstract
ABSTRACT Objective Arthritis is a chronic condition affecting hundreds of millions of people worldwide, often leading to pain and functional limitations. This study aimed to investigate the direct and indirect effects of pain on functional dependence in individuals with arthritis. Depressive symptoms and physical activity were examined as potential mediators of this relationship. Methods A total of 6972 participants with arthritis (4930 with osteoarthritis and 694 with rheumatoid arthritis) were included from the Canadian Longitudinal Study on Aging. Linear and logistic regression models were used to assess the relationships between baseline usual presence of pain or discomfort, depressive symptoms, physical activity, and functional dependence at follow-up. Results Baseline pain was positively associated with depressive symptoms (b = 0.356 [95% CI: 0.310 to 0.402]) and negatively associated with physical activity (b = −0.083 [95% CI: −0.125 to −0.042]). Functional dependence at follow-up was significantly predicted by baseline pain (log OR = 0.607 [95% CI: 0.261 to 0.952]), depressive symptoms (log OR = 0.358 [95% CI: 0.184 to 0.533]), and physical activity (log OR = −0.598 [95% CI: −0.818 to −0.378]). Mediation analysis showed that 23.3% of the total effect of pain on functional dependence was accounted for by the indirect effect through depressive symptoms (16.2%), physical activity (6.3%), and their serial combination (0.8%). Conclusions The presence of pain at baseline was associated with higher odds of functional dependence in basic and instrumental activities of daily living after a mean follow-up period of 6.3 years, with depressive symptoms and lower physical activity acting as mediators. Impact Our findings highlight the need for arthritis care to extend beyond pain management by incorporating strategies that address depressive symptoms and promote physical activity to preserve functional independence.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".