['To identify, in community dwelling elders, the determinants of sustained pain improvement or worsening.', 'A longitudinal study with two baseline and 11 monthly follow-up interviews was conducted. Pain was assessed monthly using the Parmelee adaptation of the McGill Pain Inventory.', 'Subjects included 109 Caucasian and 132 African American, Philadelphia residing Medicare recipients (65-74 years of age).', 'To identify sustained pain change (> or =2 months), the data for each subject were reconfigured to yield 10 overlapping 3-month data segments. Each segment was classified as improved or worsened pain. Other variables included: the Geriatric Depression Scale (GDS), self-rated health (SRH), physical functioning, and number of improved or worsened medical conditions.', 'Pain experienced (over 3-month periods) was typically stable. Sustained improved pain was more likely than worsened pain. Odds ratios obtained through Generalized Estimation Equation analyses showed that a 1-point increase in GDS scores increased the odds of worsened pain by 1.18 (1.11-1.30). Fair/poor SRH, being female, and having medical conditions worsen increased the odds of worsened pain by 4.04 (2.12-7.70), 1.63 (1.11-2.38), and 2.12 (1.42-3.16), respectively. Observed, statistically significant associations between these variables, except gender, and improved pain were in the opposite direction.'] Are depression and self-rated health proximal predictors of episodes of sustained change in pain in independently living , community dwelling elders?