The Relationship of Older Adults' Physical Pain to Depression and Post-Traumatic Stress Disorder (PTSD): A Review

J Geriatr Med Gerontol. 2015;1(2):007. Epub 2015 Dec 31.


Background: Physical pain is very common in older age and is often accompanied by depressive as well as PTSD symptomatology. Many conceptualizations of the comorbidity of pain with depression and with PTSD exist, but they need to be tested on older adult populations.

Purpose: This article covers existing literature on the relation between depression and pain in older age, as well as between older adults' PTSD and pain. Additionally, several physiological, cognitive, and behavioral conceptualizations of why depression and PTSD are often related to pain are presented.

Methods: The PsychInfo, PubMed, and Google Scholar databases were searched for relevant articles by utilizing the following terms in combination with chronic pain (as well as with pain alone): aging, older adults, elderly, depression, depressive, post-traumatic stress, and PTSD. Additionally, Thomson Reuters Web of Science database searches were conducted using the terms "elderly (and older adults) pain depression PTSD." This review includes various articles that conceptualize the pain-depression, pain-PTSD, and pain-depression-PTSD links, yet, due to space limitations, the review is not comprehensive. Several pertinent reviews are referenced throughout the paper for readers interested in obtaining additional information in this area.

Results: Depression and PTSD are comorbidities for pain at any age, and are characterized by several and often complex mechanisms that can exacerbate pain.

Conclusion: The comorbidity of pain and factors such as depression and PTSD in older age should be addressed in more research studies, as few investigations are available in this area on the general population of older individuals. This is particularly the case for non-Caucasian older adults living with chronic pain.

Keywords: Chronic pain; Comorbidity; Depression; Elderly; Older adults; Post-Traumatic stress disorder; Psychopathology.