Chronic pain increases the risk of decreasing physical performance in older adults: The San Luis Valley Health and Aging Study
Chronic pain increases the risk of decreasing physical performance in older adults: The San Luis Valley Health and Aging Study
复制标题
DOI：
10.1093/gerona/62.9.989
复制
发表时间：
2007-09-01
影响因子：
5.1
通讯作者：
Baxter, Judith
中科院分区：
文献类型：
--
作者：
Bryan, Lucinda L.;Grigsby, Jim;Baxter, Judith
背景疼痛经常伴随着老年人的慢性病，并可能加剧身体限制，残疾模型表明，这可能会增加残疾和降低独立性。这项研究检验了一种假设，即慢性疼痛和疼痛水平随时间的变化与身体表现的恶化有关联，而不受疾病条件的影响。在圣路易斯谷健康和老龄化研究中，我们研究了925名居住在社区的西班牙裔和非西班牙裔白人参与者在大约22个月的时间里，初始和变化的疼痛水平对观察到的身体表现的影响。控制人口统计变量、基线表现和合并症的Logistic回归模型。我们发现，无论种族如何，慢性疼痛都与身体表现的恶化有独立的联系。疼痛的强度似乎没有独立的影响。尽管多种并存(或单一的血管疾病或糖尿病)的存在也会增加身体表现恶化的风险，但在调整这些疾病条件后，慢性疼痛的独立影响仍然存在。此外，持续的慢性疼痛增加了表现恶化的风险；显然，从慢性疼痛中恢复具有显著和实质性的保护作用。疼痛本身似乎会增加身体损伤。这些结果有力地表明，控制慢性疼痛可能会通过显著减少受损的身体表现而中断负的疾病-损伤-残疾轨迹，无论疼痛背后的疾病条件如何。
Background Pain often accompanies chronic disease in older adults and may exacerbate physical limitations, which the Disablement Model suggests may increase disability and decrease independence. This study tests the hypothesis that chronic pain and change in levels of pain over time have associations with worsening physical performance independent of disease conditions.Methods. We studied the effects of initial and changing levels of pain on observed physical performance over approximately 22 months in 925 community-dwelling Hispanic and non-Hispanic white participants in the San Luis Valley Health and Aging Study. Logistic regression models controlled for demographic variables, baseline performance, and comorbidities.Results. We found that chronic pain has an independent association with worsening physical performance, regardless of ethnicity. The intensity of the pain appears to have no independent effect. Although the presence of multiple comorbidities (or vascular disease or diabetes singly) also increases the risk of a worsened physical performance outcome, an independent effect of chronic pain remains after adjusting for these disease conditions. Furthermore, ongoing chronic pain increases the risk of worsening performance; obversely, recovery from chronic pain has a significant and substantial protective effect.Conclusions. Pain in and of itself appears to increase physical impairment. These results strongly suggest that controlling chronic pain may interrupt the negative disease-impairment-disability trajectory by significantly reducing impaired physical performance, no matter the disease conditions that may underlie the pain.