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Chronic Pain in the 65+: Evaluating Functional Impacts

65 岁的慢性疼痛：评估功能影响

基本信息

批准号：
6777448
负责人：
THOMAS E RUDY
金额：
$ 48.95万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-09-15 至 2006-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6777448
关键词：
aging backache biomechanics chronic pain clinical research cognition depression emotions functional ability human old age (65+)human subject psychological aspect of aging self concept sleep social behavior

项目摘要

Chronic pain plagues approximately 50 percent of community dwelling older adults, and may cause significant disruption of physical, psychosocial, and cognitive function. Despite the prevalence of this potentially devastating problem, well-controlled studies of chronic pain in older adults that use a comprehensive multidimensional model are lacking. Chronic low back pain (CLBP) is among the most common chronic pain conditions of older adults, affecting approximately 6 million individuals in the United States who are greater than or equal to age 65. CLBP offers a robust model with which to study the comprehensive functional effects of chronic pain in the older adult because of the reliable and valid measures of observed physical capacity, self-reported disability and pathology that have been developed specifically for patients with low back pain. The purpose of this investigation is to broaden our understanding of disability in the older adult with chronic pain. Specifically, we will explore (1) the magnitude of the effect of CLBP on physical, psychosocial, and cognitive functioning in 200 community dwelling older adults greater than or equal to age 65 as compared with 200 pain-free control subjects, (2) the impact of CLBP associated psychosocial and neuropsychological dysfunction on physical function, and (3) whether older adults with chronic pain can be classified using a multiaxial taxonomy that has been demonstrated in younger chronic pain patients. The laboratory-based physical capacities testing protocol is designed to assess body mechanics, endurance and coordination using ergonomically relevant tasks (e.g., lifting, reaching). Other comprehensive multidimensional assessment measures will include those that have particular relevance to older adults, such as pain intensity, clinical measures of physical performance, disability, sleep, mood, self- efficacy, detailed measures of neuropsychological function, and self perceptions of health and well-being. This study represents the first well-controlled, comprehensive examination of the effects of chronic pain on individuals who may be most threatened by the risk of functional decline, that is, community dwelling older adults. Once the effects of chronic pain have been comprehensively described, only then can effective treatment programs be developed to help ameliorate the suffering of these older Americans.

慢性疼痛困扰着大约 50% 的社区居住老年人，并可能导致身体、心理和认知功能的严重破坏。尽管这种潜在的破坏性问题普遍存在，但仍缺乏使用全面的多维模型对老年人慢性疼痛进行良好对照的研究。慢性腰痛 (CLBP) 是老年人最常见的慢性疼痛病症之一，在美国影响着大约 600 万名 65 岁以上的人。CLBP 提供了一个强大的模型，用于研究老年人慢性疼痛的综合功能影响，因为它可以可靠有效地测量观察到的身体能力、自我报告的残疾和病理学，这些指标是专门为腰痛患者开发的。这项调查的目的是扩大我们对患有慢性疼痛的老年人的残疾的理解。具体来说，我们将探讨 (1) 与 200 名无疼痛对照受试者相比，CLBP 对 200 名年龄大于或等于 65 岁的社区居住老年人的身体、心理和认知功能的影响程度，(2) CLBP 相关的心理社会和神经心理功能障碍对身体功能的影响，以及 (3) 是否可以使用多轴分类法对患有慢性疼痛的老年人进行分类，该多轴分类法具有已在年轻的慢性疼痛患者中得到证实。基于实验室的身体能力测试方案旨在使用符合人体工程学的相关任务（例如举重、伸展）来评估身体力学、耐力和协调性。其他全面的多维评估措施将包括与老年人特别相关的措施，例如疼痛强度、身体机能的临床测量、残疾、睡眠、情绪、自我效能、神经心理功能的详细测量以及健康和福祉的自我感知。这项研究首次对慢性疼痛对功能衰退风险最大的个体（即社区居住的老年人）的影响进行了良好控制的全面检查。一旦慢性疼痛的影响得到全面描述，只有这样才能制定有效的治疗方案来帮助减轻这些美国老年人的痛苦。