THE COURSE AND CONSEQUENCES OF MUSCULOSKELETAL PAIN IN OLDER POPULATION

老年人肌肉骨骼疼痛的病程和后果

• 批准号: 7086271
• 负责人: Suzanne G. Leveille
• 金额: $ 6.77万
• 依托单位: HEBREW REHABILITATION CENTER FOR AGED
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7086271
• 关键词: accidental falls; aging; analgesia; balance; clinical research; cognition disorders; coping; functional ability; gait; human old age (65+); human subject; musculoskeletal system; pain; social support network

The role of persistent pain as a risk factor for falls and functional losses in older persons is poorly understood and seldom addressed by researchers and clinicians alike. The aims of the proposed research are 1) to examine the prevalence, history and characteristics of persistent pain in the older population, 2) to investigate the role of persistent pain, classified according to location and severity, as a cause of falls and disability in older adults and 3) to explore mediating factors such as pain management, psychological factors, and the social and environmental contexts for their influence on the pain and function relationships. This 2-year epidemiologic investigation will use a prospective population-based design. The study cohort, to be recruited door-to-door, will include 800 English-speaking persons aged 70 and older living independently in the residential Southwest section of Boston. Persons with moderate to severe cognitive impairment or those who are unable to walk 20 feet without help will be excluded. At baseline, participants will undergo a 6-hour examination that will take place in two parts, one in the home and the other, in the clinic. Measures obtained at baseline and in 2 annual follow-up visits will be conducted by a trained nurse. The primary exposure measure will be pain classified according to location and severity. The primary endpoints will be time to first fall, recurrent falls, and disability in ADL, IADL, and mobility (walking and climbing stairs). Intermediate factors that will be examined include performance measures of balance, power/strength, and gait, use of conventional (analgesics and medical therapies) and non-conventional pain management approaches, psychological distress, self-efficacy, coping, social support and network, home hazards and use of mobility aids. This study will improve our understanding of the prevalence and functional consequences of persistent pain in the older population, and will inform development of new interventions to prevent and manage pain, falls, and disability.

研究人员和临床医生对持续性疼痛作为老年人跌倒和功能丧失的危险因素知之甚少，也很少解决这一问题。拟议研究的目的是：1）检查老年人群中持续性疼痛的患病率、病史和特征；2）调查持续性疼痛（根据部位和严重程度分类）作为老年人跌倒和残疾原因的作用；3）探索中介因素，如疼痛管理、心理因素以及社会和环境背景对疼痛和功能关系的影响。这项为期两年的流行病学调查将采用基于人群的前瞻性设计。研究队列是 挨家挨户招募的人员将包括 800 名 70 岁及以上、独立生活在波士顿西南住宅区的讲英语的人。患有中度至重度认知障碍或在没有帮助的情况下无法行走 20 英尺的人将被排除在外。在基线时，参与者将接受为期 6 小时的检查，该检查将分两部分进行，一部分在家里，另一部分在诊所进行。基线和每年两次随访中获得的测量结果将由经过培训的护士进行。主要的暴露测量是根据位置和严重程度分类的疼痛。主要终点是首次跌倒的时间、反复跌倒以及 ADL、IADL 和活动能力（步行和爬楼梯）的残疾。中间的 将检查的因素包括平衡、力量/力量和步态的表现测量、传统（镇痛药和药物治疗）和非常规疼痛管理方法的使用、心理困扰、自我效能、应对、社会支持和网络、家庭危险和行动辅助设备的使用。这项研究将提高我们对老年人群中持续性疼痛的患病率和功能后果的了解，并将为开发新的干预措施以预防和管理疼痛、跌倒和残疾提供信息。