Characteristics and impact of chronic pain and pain management in older adults

项目总结/摘要 大约38.5%的65岁以上的美国人报告慢性疼痛持续6个月或更长时间。 更长.鉴于老年人口的增长，预计这一百分比还会增加 以及可能导致疼痛的慢性疾病的相关增长。慢性疼痛往往 在老年人中更为复杂，其中约70%的人描述了多个部位及以上的疼痛 60%的人描述了多种类型的疼痛。 到目前为止，还没有一个全国性的老年人大样本提供详细的纵向信息， 老年人慢性疼痛的经验;药物和非药物 老年人用于管理慢性疼痛的策略;以及慢性疼痛的影响。 以人为中心的重要结果的痛苦。拟议的研究将填补这些重大空白 通过进行第一次全国纵向研究，重点关注老年人的慢性疼痛， 成年人了在1888名老年人的大型全国样本中，其中1,232人患有慢性疼痛（即， 疼痛>6个月持续时间）和656名没有慢性疼痛，我们的目标是：1）确定 慢性疼痛的患病率和特征（即质量、严重程度、干扰），以及 确定用于管理慢性疼痛的药物和非药物治疗; 2） 评估生物、心理、社会因素的纵向差异， 有和没有慢性疼痛的老年人之间的身体和认知功能以及QoL;以及 3)检查慢性疼痛之间的纵向关系（即，最差疼痛评分）和 患者报告的结果（即，身体功能、认知功能、QoL）。我们将确定 入学时的哪些生物、心理和社会因素与 慢性疼痛的轨迹，确定亚组的老年人与不同的疼痛档案，使用 潜在的轮廓分析，并确定如何在物理功能的轨迹变化， 认知功能和生活质量与这些不同的疼痛特征类别相关。 通过更好地了解疼痛特征，与慢性疼痛相关的因素， 治疗方法和长期影响，我们将配备开发和测试量身定制 针对老年患者亚组的干预措施，目的是改善管理 慢性疼痛，以及整体功能和生活质量。

Project Summary/Abstract Approximately 38.5% of Americans >65 years of age report chronic pain lasting 6 months or longer. This percentage is expected to increase given the growth in the older adult population and the associated growth of chronic conditions that can contribute to pain. Chronic pain tends to be more complex in older adults with ~70% of them describing pain in multiple sites and over 60% describing multiple types of pain. To date, no large national sample of older adults provides detailed, longtitudinal information on the experience of chronic pain in older adults; the pharmacologic and nonpharmacologic strategies that older adults are using to manage their chronic pain; and the impact of chronic pain on important person-centered outcomes. The proposed study will fill these significant gaps in knowledge by conducting the first national longitudinal study focused on chronic pain in older adults. In a large national sample of 1888 older adults, of whom 1,232 have chronic pain (i.e., pain >6 months duration) and 656 do not have chronic pain, we aim to: 1) Determine the prevalence and characteristics (i.e. quality, severity, interference) of chronic pain as well as identify the pharmacologic and non-pharmacologic treatments used to manage chronic pain; 2) Evaluate for longitudinal differences in biological, psychological, social factors, as well as physical and cognitive function and QoL between older adults with and without chronic pain; and 3) Examine the longitudinal relationships between chronic pain (i.e., worst pain score) and patient reported outcomes (i.e., physical function, cognitive function, QoL). We will determine which biological, psychological, and social factors at enrollment are associated with changes in the trajectories of chronic pain, identify subgroups of older adults with distinct pain profiles using latent profile analysis, and determine how changes in the trajectories of physical function, cognitive function, and QoL are associated with these distinct pain profile classes. Informed by a better understanding of pain characteristics, factors associated with chronic pain, treatment approaches and long-term impact, we will be equipped to develop and test tailored interventions that target subgroups of older patients, with the goal of improving the management of chronic pain, as well as overall function and QoL.