Pain among older adults with gastrointestinal malignancies- results from the cancer and aging resilience evaluation (CARE) Registry.
Pain among older adults with gastrointestinal malignancies- results from the cancer and aging resilience evaluation (CARE) Registry.
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患有胃肠道恶性肿瘤的老年人的疼痛——来自癌症和衰老恢复力评估（CARE）登记处的结果。
DOI：
10.1007/s00520-022-07398-4
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Williams,GrantR
中科院分区：
文献类型：
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作者：
Al-Obaidi,Mustafa;Kosmicki,Sarah;Harmon,Christian;Lobbous,Mina;Outlaw,Darryl;Khushman,Moh'd;McGwin,Gerald;Bhatia,Smita;Giri,Smith;Williams,GrantR
疼痛对老年癌症患者的功能状态和心理健康的影响是一个相关的，但研究不足。我们试图确定在诊断老年人胃肠道（GI）恶性肿瘤疼痛的患病率，并评估疼痛与功能状态限制，认知和心理health.MethodsThis前瞻性横断面研究包括老年人（年龄≥ 60）与胃肠道癌症登记在CARE注册的关联。以0 - 10的数字评定量表测量疼痛。我们使用基于文献的中重度截止值为≥ 4。Logistic回归用于评估差异的功能状态，福尔斯，认知投诉，抑郁/焦虑与中度/重度疼痛，调整性别，种族，教育，民族，婚姻状况，癌症类型/阶段，和治疗phase.ResultsOur队列包括714老年人的平均年龄为70岁，59%的男性。常见的诊断包括结直肠（27.9%）和胰腺（18%）。共有43.3%报告中度/重度疼痛。在对协变量进行多变量调整后，自报中度/重度疼痛的参与者更有可能报告工具性日常生活活动受限（校正比值比[aOR] 4.3 95%可信区间[CI] 3.1- 6.1，p <0.001），日常生活活动受限（aOR 3.2 95%CI 2.0 - 5.1，p < .001），认知主诉（aOR 2.9 95%CI 1.4 - 6.0，p < .004），焦虑（aOR 2.2 95%CI 1.4 - 3.4，p < 0.01），抑郁症（aOR3.795%CI2.2 - 6.5，p <0.001）.结论疼痛在患有GI癌症的老年人中是常见的，并且与功能状态限制、认知抱怨、抑郁/焦虑。减少疼痛并最大限度地减少其对功能和心理健康的潜在影响的策略值得未来的研究。
PurposeThe impact of pain on functional status and mental health among older adults with cancer is a relevant, yet understudied. We sought to identify the prevalence of pain at diagnosis in older adults with gastrointestinal (GI) malignancies and evaluate the association of pain with functional status limitations, cognition, and mental health.MethodsThis prospective cross-sectional study included older adults (age ≥ 60) with GI cancers enrolled in the CARE Registry. Pain measured in numeric rating scale from 0 to 10. We utilized the literature based cutoff for moderate-severe as ≥ 4. Logistic regression used to assess differences in functional status, falls, cognitive complaints, and depression/anxiety associated with moderate/severe pain, adjusted for sex, race, education, ethnicity, marital status, cancer type/stage, and treatment phase.ResultsOur cohort included 714 older adults with an average mean age of 70 years and 59% male. Common diagnoses included colorectal (27.9%) and pancreatic (18%). A total of 43.3% reported moderate/severe pain. After multivariate adjusting for covariates, participants with self-reported moderate/severe pain were more likely to report limitations in instrumental activities of daily living (adjusted odds ratio [aOR] 4.3 95% confidence interval [CI] 3.1–6.1,p< .001), limitation in activities of daily living (aOR3.2 95%CI2.0–5.1,p< .001), cognitive complaints (aOR2.9 95%CI1.4–6.0,p< .004), anxiety (aOR2.2 95%CI1.4–3.4,p< 0.01), and depression (aOR3.7 95%CI2.2–6.5,p< .001).ConclusionsPain is common among older adults with GI cancers and is associated with functional status limitations, cognitive complaints, and depression/anxiety. Strategies to reduce pain and minimize its potential impact on function and mental health warrant future research.