Pain, frailty and comorbidity on older men: The CHAMP study
Pain, frailty and comorbidity on older men: The CHAMP study
复制标题
DOI：
10.1016/j.pain.2008.08.011
复制
发表时间：
2008-11-15
期刊：
影响因子：
7.4
通讯作者：
Waite, Louise M.
中科院分区：
文献类型：
--
作者：
Blyth, Fiona M.;Rochat, Stephane;Waite, Louise M.
侵入性疼痛可能会对老年人产生严重的隐性影响，老年人对额外压力的反应能力有限。脆弱被概念化为一种功能和生物模式的下降，累积在多个生理系统中，导致对额外压力的反应能力下降。我们在1705名70岁或以上的社区男性中探索了侵袭性疼痛、虚弱和共病负担之间的关系，他们参与了CHAMP研究的基线阶段，这是一项位于澳大利亚悉尼的大型健康老龄化流行病学研究。研究中9.4%的男性身体虚弱(根据常用的心血管健康研究虚弱标准)。使用自我报告和临床测量相结合的方法，我们发现虚弱和侵袭性疼痛之间存在关联，在考虑了人口统计学特征和合并疾病的数量后。自我报告抑郁情绪和关节炎(调整后的优势比为1.7(95%，可信区间为1.1-2.7)，p=0.0149)。研究发现，对抑郁情绪进行调整，而不是关节炎病史，可以缓解虚弱和侵入性疼痛之间的关系，这一发现表明，它在中枢机制中起着关键作用。此外，总体健康负担最高的男性(虚弱加上高共病负担)最有可能报告侵入性疼痛(调整后的优势比为3.0(95%可信区间1.6-5.5)，p=0.0004)。这些发现支持了这样的概念，即侵入性疼痛对于能力有限的老年男性来说是一个重要的挑战，因为他们对额外的身体压力做出反应的能力有限。据我们所知。这是第一个专门探讨疼痛和虚弱之间关系的研究。(C)2008年国际疼痛研究协会。爱思唯尔出版，版权所有。
Intrusive pain is likely to have it serious implicit on older people with limited ability to respond to additional stressors. Frailty is conceptualised as a functional and biological pattern of decline accumulating across multiple physiological systems, resulting in a decreased capacity to respond to additional stressors. We explored the relationship between intrusive pain, frailty and comorbid burden in 1705 community-dwelling men aged 70 or more who participated in the baseline phase of the CHAMP study, it large epidemiological study of healthy ageing based in Sydney, Australia. 9.4% of men in the study were frail (according to the commonly-used Cardiovascular Health Study frailty criteria). Using a combination of self-report and clinical measures, we found an association between frailty and intrusive pain that remained after accounting for demographic characteristics, number of comorbidities. self-reported depressed mood and arthritis (adjusted odds ratio 1.7 (95%, confidence interval (CI) 1.1-2.7), p = 0.0149). The finding that adjusgting for depressed mood, but not a history of arthritis, attenuated the relationship between frailty and intrusive pain points to it key role for central mechanisms. Additionally, men with the highest overall health burden (frail plus high comorbid burden) were most likely to report intrusive pain (adjusted odds ratio 3.0 (95% CI 1.6-5.5), p = 0.0004). These findings provide support for the concept that intrusive pain is an important challenge for older men with limited capacity to respond to additional physical stressors. To our knowledge. this is the first study to explore specifically the relationship between pain and frailty. (C) 2008 International Association For the Study of Pain. Published by Elsevier B.V. All rights reserved.