{
  "abstract": "BackgroundPain and depressive symptoms frequently co-occur in middle-aged and older adults, but whether changes in their co-occurrence identify different risks of subsequent disability is unclear.MethodsWe analyzed two population-based longitudinal cohorts: the Health and Retirement Study (HRS; United States; N = 9,227; 1,524 incident cases) and the Mexican Health and Aging Study (MHAS; Mexico; N = 8,633; 1,218 incident cases). Participants were free of activities of daily living (ADL) disability at baseline. We examined a four-level baseline pain–depression phenotype and four two-point transition profiles: persistently non-co-occurring, resolved, incident, and persistent co-occurrence. Incident ADL disability was assessed at the final wave. Association models used complete cases. As a secondary analysis, a prediction model developed in HRS was evaluated in MHAS.ResultsCo-occurring pain and depressive symptoms were associated with higher odds of incident ADL disability than either symptom alone in both cohorts (HRS adjusted OR 3.15, 95% CI 2.39–4.16; MHAS 3.00, 2.33–3.85, versus neither symptom). Incident and persistent co-occurrence were each associated with elevated odds (HRS OR 3.55, 2.66–4.74 vs. 3.55, 2.37–5.33; MHAS 3.46, 2.62–4.58 vs. 4.16, 2.91–5.96), while resolved co-occurrence remained associated with elevated risk (HRS OR 2.28, 1.59–3.27; MHAS 2.17, 1.60–2.96). Findings persisted after excluding participants with ADL difficulty at the intermediate assessment. The secondary prediction model achieved an AUC of 0.775 in HRS and 0.725 (95% CI 0.710–0.741) in MHAS.ConclusionRepeated assessment of pain and depressive symptoms identified reproducible transition profiles associated with subsequent ADL disability across two national aging cohorts. Both incident and persistent co-occurrence were associated with elevated risk, supporting repeated symptom assessment as a potential population-level approach to identifying adults at increased risk of loss of independence.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "Original Research",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "Kongfan Xu"
    },
    {
      "name": "Zhengqin Wang"
    },
    {
      "name": "Shougang Li"
    },
    {
      "name": "Qin Wang"
    },
    {
      "name": "Bin Shao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6my248qfackcr.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.2010970",
  "fulltext_url": null,
  "id": "6my248qfackcr",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.2010970",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "feed-journal",
      "medicine/epidemiology-public-health"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6my248qfackcr.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T06:20:11Z",
      "native_id": "10.3389/fpubh.2026.2010970",
      "source": "feed-frontiers",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.2010970"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "feed-journal:medicine/epidemiology-public-health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Pain–depression co-occurrence, longitudinal transitions, and incident ADL disability: a two-cohort study",
  "title_text": "Pain–depression co-occurrence, longitudinal transitions, and incident ADL disability: a two-cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T06:20:11Z",
  "url": "https://research.draconitic.com/paper/6my248qfackcr",
  "venue": "Frontiers in Public Health",
  "versions": []
}