A Painful Reality Check? Examining the Accuracy of Subjective Survival Probabilities by Pain Interference and Depression Status.

PURPOSE: Pain and depression are linked to higher mortality risk and lower subjective survival probabilities (SSPs). We examine if SSPs for individuals with pain and depression match their actual lifespans.

METHODS: Using data on 12,745 Health and Retirement Study respondents aged 57-89 in 2000 with follow-up through 2018, we assessed whether respondents' SSPs were "correct," "underestimated," or "overestimated" relative to their lifespans. Adjusted multinomial logistic regressions predicted SSP accuracy based on pain interference, depression, and their interaction.

RESULTS: Severe or interfering pain (i.e., high impact pain) was associated with a 25% higher risk of underestimating SSPs (RRR = 1.25, = .04), and depression increased the risk by 49% (RRR = 1.49, < .001). High impact pain and depression also corresponded with lower average SSPs and higher mortality risk.

CONCLUSION: High impact pain and depression increase the risk of underestimating longevity. Future research should explore the impact on health and financial decisions in older adults.