Center for epidemiologic studies depression scale (ces-d) factor structure among older adults with osteoarthritis: associations with pain and disability

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This analysis evaluated the association of depressive factors with symptoms of osteoarthritis of the knee including pain and disability. Analyses used a sample of community-dwelling older adults. A comparison of potential confirmatory models for the Center for Epidemiologic Studies Depression (CES-D) Scale was performed. Resultant factors of depression were used to predict cross-sectional and longitudinal pain and disability after controlling for demographic and general health covariates. Results indicated a second-order four-factor model had the best fit in this population for the CES-D. In cross-sectional regressions the somatic/vegetative factor was the sole unique predictor of variance in pain of the CES-D factors individually. In addition, the CES-D factors as a group accounted for significant unique variance in both pain and disability. Longitudinal regressions found that CES-D factors as a group significantly predicted change in disability and change in pain over one year; however, none of the CES-D factors had significant coefficients. Results support a biopsychosocial evaluation of depression in osteoarthritis, suggest depression as a unidimensional construct predicts increased pain and disability, and support the continued use of the CES-D in community populations of older adults with osteoarthritis.

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