The bidirectional relationship between chronic joint pain and frailty: data from the Investigating Musculoskeletal Health and Wellbeing cohort.
The bidirectional relationship between chronic joint pain and frailty: data from the Investigating Musculoskeletal Health and Wellbeing cohort.
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DOI：
10.1186/s12877-023-03949-4
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发表时间：
2023-05-05
期刊：
影响因子：
4.1
通讯作者：
Walsh, David A.
中科院分区：
文献类型：
--
作者：
Chaplin, Wendy J.;McWilliams, Daniel F.;Millar, Bonnie S.;Gladman, John R. F.;Walsh, David A.
疼痛和虚弱是联系在一起的，但人们对这种关系的理解还不够充分。我们的目的是测试关节疼痛和虚弱之间是否存在单向或双向的关系。数据来自调查肌肉骨骼健康和福祉，一个总部位于英国的队列。前一个月的平均关节疼痛严重程度使用11分数字评定量表(NRS)进行评估。使用脆弱问卷将脆弱分类为存在/不存在。多变量回归评估了关节疼痛和虚弱之间的联系，并根据年龄、性别和BMI分级进行了调整。两波交叉滞后路径模型允许同时探索基线和1年时疼痛强度和虚弱之间的合理原因路径。过渡期采用t检验进行评估。1,179名参与者接受了研究，其中53%是女性，年龄中位数为73岁(范围从60岁到95岁)。FILL将176名(15%)参与者在基线时归类为虚弱。平均(SD)基线疼痛评分为5.2(2.5)。在172名(99%)虚弱的参与者中观察到疼痛神经递质受体 ≥ 4。疼痛严重程度与基线时的虚弱程度相关(AOR 1.72(95%CI 1.56至1.92))。在交叉滞后路径分析中，较高的基线疼痛预测1年的脆弱[β = 0.25%，(95%CI 0.14至0.36)，p <； 0.001]，基线脆弱预测较高的1年疼痛[β = 0.06，(95%CI 0.003至0.11)，p = 0.040]。一年以上转为虚弱状态的参与者在基线时的平均疼痛评分(6.4(95%可信区间5.8至7.1))高于不虚弱的参与者(4.7(95%可信区间4.5至4.8))，p <； 0.001。疼痛和虚弱之间的双向关系可能会导致一种恶性循环，在这种恶性循环中，两者都会加速对方的进步。这证明试图通过解决疼痛和将疼痛措施作为脆弱研究的结果来预防脆弱是合理的。网上版载有补充材料，可在10.1186/s12877-023-03949-4查阅。
Pain and frailty are associated, but this relationship is insufficiently understood. We aimed to test whether there is a unidirectional or bidirectional relationship between joint pain and frailty. Data were from Investigating Musculoskeletal Health and Wellbeing, a UK-based cohort. Average joint pain severity over the previous month was assessed using an 11-point numerical rating scale (NRS). Frailty was classified as present/absent using the FRAIL questionnaire. Multivariable regression assessed the association between joint pain and frailty, adjusted for age, sex, and BMI class. Two-wave cross-lagged path modelling permitted simultaneous exploration of plausible causal pathways between pain intensity and frailty at baseline and 1-year. Transitions were assessed using t-tests. One thousand one hundred seventy-nine participants were studied, 53% female, with a median age of 73 (range 60 to 95) years. FRAIL classified 176 (15%) participants as frail at baseline. Mean (SD) baseline pain score was 5.2 (2.5). Pain NRS ≥ 4 was observed in 172 (99%) of frail participants. Pain severity was associated with frailty at baseline (aOR 1.72 (95%CI 1.56 to 1.92)). In cross-lagged path analysis, higher baseline pain predicted 1-year frailty [β = 0.25, (95%CI 0.14 to 0.36), p < 0.001] and baseline frailty predicted higher 1-year pain [β = 0.06, (95%CI 0.003 to 0.11), p = 0.040]. Participants transitioning to frailty over one year had higher mean pain scores (6.4 (95%CI 5.8 to 7.1)) at baseline than those who remained non-frail (4.7 (95%CI 4.5 to 4.8)), p < 0.001. The bidirectional relationship between pain and frailty could lead to a vicious cycle in which each accelerates the other’s progression. This justifies attempts to prevent frailty by addressing pain and to include pain measures as an outcome in frailty studies. The online version contains supplementary material available at 10.1186/s12877-023-03949-4.
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DOI：
10.1016/j.jamda.2016.08.020
发表时间：
2017-02-01
影响因子：
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