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行动能力受限和跌倒相关因素导致患有慢性肌肉骨骼疼痛的老年人健康相关生活质量下降。

Mobility Limitations and Fall-Related Factors Contribute to the Reduced Health-Related Quality of Life in Older Adults With Chronic Musculoskeletal Pain.

作者信息

Stubbs Brendon, Schofield Pat, Patchay Sandhi

机构信息

School of Health and Social Care, University of Greenwich, London, U.K.

School of Psychology, University of Greenwich, London, U.K.

出版信息

Pain Pract. 2016 Jan;16(1):80-9. doi: 10.1111/papr.12264. Epub 2014 Dec 3.

DOI:10.1111/papr.12264
PMID:25469983
Abstract

PURPOSE

To investigate (1) the prevalence of chronic musculoskeletal pain (CMP) among a sample of community-dwelling older adults and (2) health-related quality of life (HRQOL) in people with CMP, particularly the association with mobility limitations and falls-related factors.

METHOD

Overall, 295 (response rate 73.5%) community-dwelling older adults were recruited across 10 sites. CMP was assessed using recognized criteria. In the sample of people with CMP, a hierarchical multiple regression analysis was conducted with HRQOL as the dependent variable and a number of independent variables were then inserted into the model. After controlling for demographic and medical variables, mobility (timed up and go (TUG), walking aid use, sedentary behavior) and fall-related factors (falls history, balance confidence, concerns about consequences of falling) were inserted into the model at the second step and changes in adjusted R(2) noted.

RESULTS

Within our sample of older adults, 52% had CMP (154/295). Compared to the group without CMP of similar age (n = 141), those with CMP had reduced HRQOL and profound mobility limitations and more falls risk factors (P < 0.001). The mobility and falls explanatory variables increased the variance explained within HRQOL from 14% to 36% (adjusted R(2) change 20%) in those with CMP. Sedentary behavior, pain interference, concerns about the consequences of falling, falls history, TUG scores, and balance confidence all remained significant predictors of HRQOL in the fully adjusted model in the CMP sample.

CONCLUSION

Older adults with CMP have pronounced mobility limitations and increased falls risk factors, and these are associated with a marked reduction in HRQOL. Future prospective research is required to build on this cross-sectional study.

摘要

目的

调查(1)社区居住的老年人样本中慢性肌肉骨骼疼痛(CMP)的患病率,以及(2)CMP患者的健康相关生活质量(HRQOL),特别是与行动能力受限和跌倒相关因素的关联。

方法

总共在10个地点招募了295名社区居住的老年人(应答率73.5%)。使用公认的标准评估CMP。在CMP患者样本中,以HRQOL作为因变量进行分层多元回归分析,然后将多个自变量纳入模型。在控制了人口统计学和医学变量后,第二步将行动能力(计时起立行走测试(TUG)、助行器使用、久坐行为)和跌倒相关因素(跌倒史、平衡信心、对跌倒后果的担忧)纳入模型,并记录调整后R²的变化。

结果

在我们的老年人样本中,52%患有CMP(154/295)。与年龄相仿的无CMP组(n = 141)相比,CMP患者的HRQOL较低,行动能力严重受限,跌倒风险因素更多(P < 0.001)。在CMP患者中,行动能力和跌倒的解释变量使HRQOL的解释方差从14%增加到36%(调整后R²变化20%)。在CMP样本的完全调整模型中,久坐行为、疼痛干扰、对跌倒后果的担忧、跌倒史、TUG分数和平衡信心仍然是HRQOL的显著预测因素。

结论

患有CMP的老年人行动能力明显受限,跌倒风险因素增加,这些与HRQOL的显著降低有关。需要在这项横断面研究的基础上进行未来的前瞻性研究。

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