The Temporal Relationship between Pain Intensity and Pain Interference and Incident Dementia
The Temporal Relationship between Pain Intensity and Pain Interference and Incident Dementia
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DOI：
10.2174/1567205016666181212162424
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发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
--
作者：
Ezzati, Ali;Wang, Cuiling;Lipton, Richard B.
背景：基于横断面研究，慢性疼痛在老年人中很常见，并且与认知功能障碍有关。然而，在社区样本中慢性疼痛和痴呆事件之间的纵向关联尚不清楚。目的：我们旨在评估疼痛强度和疼痛干扰与社区老年人痴呆事件之间的关联。方法：参与者是来自爱因斯坦衰老研究（EAS）的1,114名70岁或以上的人，对纽约布朗克斯县社区居住老年人的纵向队列研究。主要结果测量是痴呆事件，使用DSM-IV标准诊断。使用SF-36问卷中的项目测量首次年度访视前一个月的疼痛强度和干扰。疼痛强度和疼痛干扰进行了评估，作为预测事件痴呆症的时间使用考克斯比例风险模型，同时控制潜在的confersider.Results：在参与者中，114个人发展痴呆症超过平均4.4年（SD=3.1）的后续行动。模型显示，疼痛强度对发展痴呆症的时间没有显着影响，而更高水平的疼痛干扰与痴呆症的高风险相关。在模型中，包括疼痛强度和干扰事件的痴呆的预测，疼痛干扰事件的痴呆有显着的效果，和疼痛强度保持non-significant.Conclusion：作为一个潜在的可补救的危险因素，疼痛干扰认知功能下降的机制值得进一步探讨。
Background: Chronic pain is common among older adults and is associated with cognitive dysfunction based on cross-sectional studies. However, the longitudinal association between chronic pain and incident dementia in community-based samples is unknown.Objective: We aimed to evaluate the association of pain intensity and pain interference with incident dementia in a community-based sample of older adults.Methods: Participants were 1,114 individuals 70 years of age or older from Einstein Aging Study (EAS), a longitudinal cohort study of community-dwelling older adults in the Bronx County, NY. The primary outcome measure was incident dementia, diagnosed using DSM-IV criteria. Pain intensity and Interference in the month prior to first annual visit were measured using items from the SF-36 questionnaire. Pain intensity and pain interference were assessed as predictors of time to incident dementia using Cox proportionate hazards models while controlling for potential confounders.Results: Among participants, 114 individuals developed dementia over an average 4.4 years (SD=3.1) of follow-up. Models showed that pain intensity had no significant effect on time to developing dementia, whereas higher levels of pain interference were associated with a higher risk of dementia. In the model that included both pain intensity and interference as predictors of incident dementia, pain interference had a significant effect on incident dementia, and pain intensity remained non-significant.Conclusion: As a potential remediable risk factor, the mechanisms linking pain interference to cognitive decline merit further exploration.