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Recall bias affects pain and depression assessment in multimorbidity: a pilot study
Irina Mindlis1, M Carrington Reid2, Thomas L Rodebaugh3
1https://ror.org/05vt9qd57Parker Health Group Division of Geriatrics, Department of Family Medicine and Community Health, Robert Wood Johnson Medical School of Rutgers University, USA.
Primary Health Care Research & Development
|July 3, 2026
Summary
Older adults with multiple chronic conditions (OAMM) tend to overreport pain and depression symptoms due to recall bias. This suggests primary care assessments relying on memory may be inaccurate.
Area of Science:
- Gerontology
- Psychiatry
- Primary Care Medicine
Background:
- Older adults with multiple chronic conditions (OAMM) often manage depression and pain in primary care.
- Symptom assessment typically relies on retrospective recall, which may be prone to bias.
- Recall bias for depression and pain in OAMM has not been previously explored.
Purpose of the Study:
- To investigate discrepancies between prospectively measured and recalled depression and pain symptoms in OAMM.
- To identify factors associated with recall discrepancies.
- To explore potential recency effects in symptom recall.
Main Methods:
- Analysis of data from a 14-day pilot feasibility trial using ecological momentary assessment (EMA).
- Comparison of retrospectively assessed symptoms with EMA-measured data over two weeks.
- Examination of correlations between baseline characteristics, recency, and symptom recall discrepancies.
Main Results:
- Overreporting of most symptoms was observed, particularly for pain intensity and fatigue.
- No significant association was found for recalled appetite or sleep issues compared to EMA data.
- Recency effects were suggested, with day 14 pain intensity, mood, and negative self-thoughts correlating with recall discrepancies.
Conclusions:
- Preliminary evidence suggests recall bias, including overreporting and recency effects, exists for pain and depression symptoms in OAMM.
- The findings highlight potential inaccuracies in primary care symptom assessments relying on patient recall.
- Further research is warranted to address recall bias in OAMM symptom management.
