Abstract / Summary
Musculoskeletal pain (MSP) and dementia are prevalent in aging populations, yet the relationship linking them remains inadequately understood. This research explored whether depressive symptoms mediated the association between MSP and dementia risk. The China Health and Retirement Longitudinal Study (CHARLS), comprising 11,404 participants for cross-sectional analysis and 8,093 for longitudinal study (2011–2015), provided the data. The relationships between MSP and dementia were evaluated using logistic regression and Cox proportional hazards models, with sensitivity, subgroup, and Kaplan–Meier analyses performed. Mediation analysis assessed the role of depressive symptoms. A graded association was noted by the number of pain sites, and MSP was substantially linked to increased chances of dementia in cross-sectional analysis (adjusted OR = 3.34, 95% CI: 2.86–3.91). MSP was linked to a higher risk of incident dementia in longitudinal studies (adjusted HR = 1.51, 95% CI: 1.23–1.84), and persistent MSP was linked to a higher risk (HR = 2.10, 95% CI: 1.66–2.65). Participants with MSP had a greater cumulative incidence of dementia, according to Kaplan-Meier curves. Mediation analysis indicated that depressive symptoms explained a portion of the association, accounting for 37.47% of the total effect for MSP and 25.81% for persistent MSP. MSP was associated with an elevated risk of dementia, especially when it was persistent or involved multiple sites. Depressive symptoms partially accounted for these associations, which demonstrates the relevance of integrating musculoskeletal and mental health management in clinical practice, including orthopedic care, to support dementia prevention.