School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Qld., Australia.
Gerontology. 2009;55(6):683-93. doi: 10.1159/000235655. Epub 2009 Aug 18.
Chronic headache is common in the elderly, but there is little specific research on the impact on quality of life of headache and beliefs about pain in this age group. This study investigated the influence of headache type as well as headache frequency (> or =15 headache days/month vs. <15 headache days/month) on quality of life and determined the relationships between elder's well-being, pain beliefs and related headache features including commonly reported neck pain. 118 headache subjects and 44 non-headache controls, aged 60-75 years, were recruited from the community. Subjects completed a headache questionnaire for classification purposes, the SF-36, the Geriatric Depression Scale-short form (GDS-S), the Survey of Pain Attitudes (SOPA-35) and the Neck Disability Index (NDI). The results revealed that elders with headache compared to the control group scored lower on most SF-36 domains, higher on the GDS-S (p < 0.05) and comparably on the SOPA-35 (p > 0.05), noting that the GDS score was below the threshold value for depression. These measures were not different between the headache types but were influenced by headache frequency. Subjects with headaches > or =15 days/month scored lowest on SF-36 domains and highest on GDS-S questionnaire compared to those with headache <15 days/month and controls (all p < 0.05). The mean NDI score in the headache subjects indicated the presence of mild to moderate neck pain and disability. There were no strong relationships between well-being and headache frequency, intensity and length of headache history. The NDI score had the greatest influence on physical well-being and GDS-S score on mental well-being (p < 0.001). The results suggest that frequency of headache has an impact on health-related quality of life in elders. Notably, the level of neck pain and disability is an important factor influencing well-being and may warrant attention in the management of elders with chronic headache.
慢性头痛在老年人中很常见，但针对该年龄段人群的头痛对生活质量的影响以及对疼痛的信念，相关的具体研究却很少。本研究调查了头痛类型以及头痛频率（每月大于等于 15 天头痛日和每月小于 15 天头痛日）对生活质量的影响，并确定了老年人的健康状况、疼痛信念与相关头痛特征（包括常见的颈部疼痛）之间的关系。118 名头痛患者和 44 名非头痛对照者，年龄 60-75 岁，从社区招募。受试者完成了头痛问卷分类，SF-36 问卷，老年抑郁量表短表（GDS-S），疼痛态度调查（SOPA-35）和颈部残疾指数（NDI）。结果显示，与对照组相比，头痛患者在大多数 SF-36 维度的得分较低，GDS-S 得分较高（p <0.05），SOPA-35 得分相当（p >0.05），但 GDS 评分低于抑郁的阈值。这些测量结果在头痛类型之间没有差异，但受头痛频率的影响。每月头痛大于等于 15 天的患者在 SF-36 各维度的得分最低，GDS-S 问卷的得分最高，与每月头痛小于 15 天的患者和对照组相比（均 p <0.05）。头痛患者的平均 NDI 评分表明存在轻度至中度颈部疼痛和残疾。健康状况与头痛频率、头痛强度和头痛病史长度之间没有强相关性。NDI 评分对身体健康的影响最大，GDS-S 评分对心理健康的影响最大（p <0.001）。结果表明，头痛频率对老年人的健康相关生活质量有影响。值得注意的是，颈部疼痛和残疾的程度是影响健康状况的一个重要因素，在管理慢性头痛的老年人时应予以关注。
