Body Pain and Depressive Symptoms: Patterns and Associations in Middle-Aged and Older Chinese Adults

Background: Depressive symptoms (DS) and body pain are prevalent conditions that significantly impact the quality of life of older adults, often co-occurring with chronic diseases. This study aimed to explore the patterns of body pain characteristics and their association with DS among middle-aged and older Chinese adults. Methods: This cross-sectional study analysed data from 16,039 participants aged ≥45 years in the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS). DS were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale (CESD-10). Body pain characteristics included pain severity and location. Multiple linear regression and mediation analyses were conducted to examine the relationships between chronic diseases, body pain, and DS. Results: Among participants, 5442 (33.9%) reported DS (CESD-10 score ≥12). The DS group showed significantly higher body pain severity (2.66 ± 1.42 vs. 1.84 ± 1.11, p < 0.001) and more painful body parts (5.06 ± 3.87 vs. 3.68 ± 3.03, p < 0.001) compared to the non-depressive group. Both pain severity and number of pain sites were independently associated with higher CESD-10 scores. Mediation analysis revealed that body pain severity mediated 29.0% of the total effect between chronic diseases and DS. Conclusion: Body pain plays a significant mediating role in the relationship between chronic diseases and DS among middle-aged and older Chinese adults. These findings emphasize the importance of implementing comprehensive healthcare approaches that integrate pain management with mental health support in primary care settings.