Chronic Pain in the 65+: Evaluating Functional Impacts

65 岁的慢性疼痛：评估功能影响

• 批准号: 6619626
• 负责人: THOMAS E RUDY
• 金额: $ 47.76万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-15 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6619626
• 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

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%的社区老年人，并可能导致身体、社会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，但缺乏使用全面多维模型的老年人慢性疼痛的良好控制研究。慢性腰痛（CLBP）是老年人最常见的慢性疼痛疾病之一，在美国大约有600万大于或等于65岁的人受到影响。CLBP为研究老年人慢性疼痛的综合功能影响提供了一个强大的模型，因为它可靠有效地测量了观察到的身体能力、自我报告的残疾和病理，这些都是专门为腰痛患者开发的。本研究的目的是拓宽我们对老年慢性疼痛致残的认识。具体而言，我们将探讨(1)与200名无痛对照受试者相比，200名年龄大于或等于65岁的社区老年人CLBP对身体、社会心理和认知功能的影响程度；(2)CLBP相关的社会心理和神经心理功能障碍对身体功能的影响；(3)老年慢性疼痛患者是否可以使用在年轻慢性疼痛患者中已经证实的多轴分类法进行分类。基于实验室的身体能力测试方案旨在评估人体力学，耐力和协调，使用符合人体工程学的任务（例如，举起，伸手）。其他综合多维评估措施将包括那些与老年人特别相关的措施，如疼痛强度、身体表现、残疾、睡眠、情绪、自我效能的临床措施、神经心理功能的详细措施以及对健康和福祉的自我感知。这项研究首次对慢性疼痛对最容易受到功能衰退风险威胁的个体（即社区居住的老年人）的影响进行了控制良好的全面检查。一旦慢性疼痛的影响被全面描述，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。