Distress as a mediator for pain and activities of daily living in older adults with fibromyalgia

IntroductionPain, distress, and activities of daily living impact the lives of those with chronic pain. This study investigated distress (depressive symptoms, anxiety) on the relationship between pain (intensity and pain interference) and activities of daily living in individuals with fibromyalgia while controlling for age.MethodsThe current cross-sectional investigation focused on data from 123 men and women with fibromyalgia. Pain intensity, pain interference and anxiety were measured on 0-10 Likert type scales from the National Fibromyalgia Assessment Questionnaire. Depressive symptoms were assessed using the Beck Depression Inventory II. Activities of daily living (basic, instrumental) were measured with the Physical Activity Inventory Scale.ResultsIt was hypothesized that the relationships between pain intensity and pain interference and activities of daily living in individuals with fibromyalgia would be mediated by the construct of distress while controlling for age. Mediation significantly occurred in both models as predicted. However, those who were older reported lower levels of pain intensity and distress than their younger counterparts, which may be related to time since diagnosis or other factors.DiscussionResults of this study suggest that individuals with chronic pain conditions would benefit from treatment options which address distress, specifically depressive symptoms and anxiety

Subdivisions of the Auditory Midbrain (N. Mesencephalicus Lateralis, pars dorsalis) in Zebra Finches Using Calcium-Binding Protein Immunocytochemistry

The midbrain nucleus mesencephalicus lateralis pars dorsalis (MLd) is thought to be the avian homologue of the central nucleus of the mammalian inferior colliculus. As such, it is a major relay in the ascending auditory pathway of all birds and in songbirds mediates the auditory feedback necessary for the learning and maintenance of song. To clarify the organization of MLd, we applied three calcium binding protein antibodies to tissue sections from the brains of adult male and female zebra finches. The staining patterns resulting from the application of parvalbumin, calbindin and calretinin antibodies differed from each other and in different parts of the nucleus. Parvalbumin-like immunoreactivity was distributed throughout the whole nucleus, as defined by the totality of the terminations of brainstem auditory afferents; in other words parvalbumin-like immunoreactivity defines the boundaries of MLd. Staining patterns of parvalbumin, calbindin and calretinin defined two regions of MLd: inner (MLd.I) and outer (MLd.O). MLd.O largely surrounds MLd.I and is distinct from the surrounding intercollicular nucleus. Unlike the case in some non-songbirds, however, the two MLd regions do not correspond to the terminal zones of the projections of the brainstem auditory nuclei angularis and laminaris, which have been found to overlap substantially throughout the nucleus in zebra finches

Depressive Symptoms Mediate the Influence of Fibromyalgia Status on Physical Performance and BMI in Aging Adults

Abstract Fibromyalgia is a chronic pain condition that is frequently accompanied by comorbid conditions, including depression. Depression is associated with reduced physical functioning and health disproportionately affecting middle-aged and older adults with fibromyalgia. This study examined depressive symptoms as a mechanism through which FM status is associated with BMI and physical performance among adults in mid-to-late-life. Participants included 250 community-dwelling middle-aged and older adults (82% female) with (59%) or without (41%) fibromyalgia (M age = 64.44, SD = 9.16). Depressive symptoms were measured using the Beck Depression Inventory-II, BMI was objectively assessed, and physical performance was measured using the Fullerton Advanced Balance scale, 6-Minute Walk Test, 30-Second Chair Stand, and 8-Foot Up and Go Test. Physical performance measure analyses were adjusted for age. Asymptotic mediation analyses revealed that fibromyalgia status was indirectly associated with higher BMI (95% CI [.18, 16.74]), and poorer performance in the Fullerton Advanced Balance (CI [-2.93, -1.24]), 6-Minute Walk Test (CI [-73.75, -35.35]), 30-Second Chair Stand (CI [-2.45, -1.16]), and 8-Foot Up and Go test (CI [.35, .92]) via depressive symptoms. Participants with fibromyalgia reported greater depressive symptoms which was subsequently associated with greater BMI and reduced physical performance. Findings support depressive symptoms as one factor through which fibromyalgia status is associated with higher obesity risk and reduced physical function in middle-aged and older adults with fibromyalgia. This study supports fibromyalgia status as a critical consideration when evaluating the health and disability risk of aging adults.</jats:p

Examining Cardiovascular Disease Risk Profiles Among Older Adults With and Without Fibromyalgia

Abstract Introduction: Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality in the United States. Preexisting chronic health conditions may be confer increased CVD risk, specifically fibromyalgia (FM), a chronic condition characterized by widespread pain, fatigue, stiffness, and concentration problems. CVD risk increases with normal aging; however, characteristics of FM are suggested to exacerbate health profiles in normal aging processes that may contribute to increased CVD risk. Method: The sample included 221 older adults (M=63.40, SD=8.86; 82% female; 88% White/European American) and 55% reported an FM diagnosis. CVD risk factors were entered separately in a five-block hierarchical binary logistic regression model as predictors and included: cardiorespiratory fitness using the six-minute walk, BMI, standing and lying mean arterial pressure (MAP), and depression using the Beck Depression Inventory. Results: Logistic regression analyses revealed that poorer cardiorespiratory fitness (OR=.99, 95% CI=.99-1.00, p=.001), greater depressive symptoms (OR=1.35, 95% CI=1.19-1.53, p&amp;lt; .001) and lower standing MAP (OR=.98, 95% CI=.96-1.00, p=.036) were associated with higher odds of an FM diagnosis. However, no differences in lying MAP (OR=1.02, 95% CI=1.00-1.04, p=.137) or BMI (OR=1.02, 95% CI=.95-1.10, p=.644) for an FM diagnosis emerged. Discussion: These data support the importance of examining the health profiles of persons with FM in the context of CVD risk. Experiences of FM may produce distinct health profiles with characteristics that serve as both protective and risk factors in the context of CVD.</jats:p

Pain intensity and physical performance among individuals with fibromyalgia in mid-to-late life: The influence of depressive symptoms

This study investigated the mediating role of depressive symptoms among 147 middle-aged and older adults with FM in the relationship between pain intensity and 4 objective measures of physical performance: Fullerton Advanced Balance scale (FAB), 6-Minute Walk Test (6MWT), 30-Second Chair Stand (30SCS), and 8-Foot Up and Go Test (8FUPGT). Asymptotic mediation analyses revealed that depressive symptoms fully mediated the relationship between pain intensity and FAB (95% CI [−0.40, −0.10]) and 8FUPGT (CI [0.02, 0.11]) and partially mediated the relationship to 6MWT (CI [−9.15, −2.20]) and 30SCS (CI [−0.29, −0.06]). Findings support the evaluation of co-morbid depression in FM. </jats:p

Perceived Stress and Life Stressors in Adults With and Without Fibromyalgia

Abstract Fibromyalgia (FM) is a widespread chronic pain condition often accompanied by comorbid conditions, such as depression, which may impact perception of stress severity. The current study examined perceived stress and life stressors in adults ages 50 and older with and without FM. It was hypothesized that individuals with FM and/or depression would subjectively rate stressors as more severe than those without. Ninety-four participants (52% with FM, 78% female) aged 50 to 93 (M = 67.72, SD = 9.26) were administered the Perceived Stress Scale (PSS) to measure perception of stress and an updated version of the Social Readjustment Rating Scale (SRRS) to assess stressors (i.e., major life events). The difference between the SRRS pre-determined values and participants' subjective ratings was calculated. Difference scores indicated that self-reported severity exceeded standardized values. Hierarchical regression analyses revealed that older adults and men were less likely to report exaggerated stress severity. Controlling for age and gender, individuals with FM were significantly more likely to report stress severity far above standardized severity scores. Both depression and chronic pain impact stress ratings, but when controlling for the former, FM impact was no longer significant, suggesting that the impact is significantly greater for depression. Results also found a significant interaction between FM status and depression for perceived stress, but not for life event stressors, which may further emphasize the distinctions between the two measures. The findings underline the importance of assessing different types of stress and stressors in individuals with chronic pain and other related comorbidities.</jats:p