DEPRESSION, DISABILITY AND PAIN IN OSTEOARTHRITIS

这项研究将考察疼痛、抑郁和 患有骨性关节炎的老年人的功能限制。最多的 在晚年生活中常见的疼痛来源和功能限制， 骨性关节炎(OA)影响至少一半甚至90%的 所有65岁及以上人士。虽然慢性病和它的 已知伴随的疼痛和残疾与 令人惊讶的是，关于晚年抑郁症的研究很少 解决骨关节炎的情感后果。这项研究 因此将整合慢性病文献中的知识 以及一般的残疾、疼痛、关节炎和抑郁，以测试 骨性关节炎严重程度与其严重程度相互关系的纵向模型 疼痛和功能受限的直接表现，以及由此而来的 对情绪状态的影响。具体目标是：1)记录程度 患有膝骨性关节炎症状的老年人的抑郁；2)至 阐明客观严重程度之间的横断面联系 骨关节炎、疼痛、功能受限和抑郁；3)至 审视个人特征和应对策略如何适中 疾病严重程度、功能受限、疼痛和 自控感与无助感对抑郁的影响 疾病效应，以及4)测试相互之间的协变的纵向模型 经历了疼痛、抑郁和功能限制，这是一种“抑郁” 随着时间的推移，这三个变量相互补充。这些 将通过对400名老年人进行为期4年的纵向研究来实现这些目标 膝关节骨性关节炎。进入这项研究后，受访者将拥有 接受了广泛的检查以确定客观的严重性 骨性关节炎的变化。他们还将完成自我报告的措施 疼痛、功能受限、抑郁、应对策略，以及 人口统计和其他个人特征。基线数据将揭示 一般健康状况、骨性关节炎严重程度、 疼痛、功能受限和抑郁情绪，以及缓和 个人特征对这些相互关系的影响。二 每年一次的跟踪访谈将确定疼痛变化的预测因素， 功能障碍和抑郁症，并阐明可能的原因 老年骨性关节炎患者中这些变量的变化顺序。

This research will examine relationships among pain, depression, and functional limitations among older persons with osteoarthritis. The most common source of pain and functional limitations in later life, osteoarthritis (OA) affects at least half and perhaps as many as 90% of all persons aged 65 and over. Although chronic illness and its accompanying pain and disability are known to be associated with depression in late life, there has been surprisingly little research addressing the affective consequences of osteoarthritis. This research will therefore integrate knowledge from the literatures on chronic illness and disability in general, pain, arthritis, and depression to test a longitudinal model of interrelationships among severity of OA, its immediate manifestation in pain and functional limitations, and consequent effects on emotional state. Specific aims are: 1) to document the extent of depression among older persons with symptomatic OA of the knee; 2) to explicate cross-sectional associations among objective severity of osteoarthritis, pain, functional limitations, and depression; 3) to examine how personal characteristics and coping strategies moderate associations among disease severity, functional limitations, pain, and depression as a function of perceived control vs. helplessness regard disease effects, and 4) to test a longitudinal model of covariation among experienced pain, depression, and functional limitations as a "downward spiral" in which the three variables feed one another over time. These aims will be achieved in a 4-year longitudinal study of 400 older persons with OA of the knee. On entering the study, respondents will have undergone extensive examination to determine the objective severity of osteoarthritic changes. They will also complete self-report measures of pain, functional limitations, depression, coping strategies, and demographic and other personal characteristics. Baseline data will reveal cross-sectional interrelationships among general health, severity of OA, pain, functional limitations, and depressed mood, as well as moderating influences of personal characteristics on those interrelationships. Two yearly follow-up interviews will identify predictors of change in pain, functional limitations and depression, and elucidate the likely causal ordering of changes in those variables among elderly OA patients.