The association of age, pain, and fatigue with physical functioning and depressive symptoms in persons with spinal cord injury

Context/objective: To describe the relationship of pain and fatigue with physical and psychological functioning in adults with spinal cord injury (SCI). Design: Cross-sectional survey. Setting: Community-based survey. Participants: Convenience sample of individuals with SCI. Intervention: Not applicable. Outcome measures: Physical functioning (Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Functioning item bank items), depression (Patient Health Questionnaire-9 (PHQ-9)), pain severity (0-10 Numerical Rating Scale (NRS)), and fatigue (0-10 NRS). Results: Pain and fatigue were independently associated with depression, but only pain was associated with physical functioning. Additionally, depression was more severe among middle-aged participants relative to younger or older participants. Physical functioning declined with increasing age, as well as with higher level of injury. Conclusions: The findings support the need for continued development of effective treatments for both pain and fatigue in order to prevent and mitigate the negative effects these symptoms can have on functioning.