Rottenberg Yakir, Jacobs Jeremy M, Stessman Jochanan
Institute for Aging Research, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel, and the Hebrew University-Hadassah Medical School, Jerusalem, Israel; Department of Oncology, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel, and the Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Institute for Aging Research, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel, and the Hebrew University-Hadassah Medical School, Jerusalem, Israel; Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel, and the Hebrew University-Hadassah Medical School, Jerusalem, Israel.
J Am Med Dir Assoc. 2015 Mar;16(3):264.e1-5. doi: 10.1016/j.jamda.2014.12.006. Epub 2015 Feb 3.
The epidemiology of chronic pain with advancing age remains poorly established. Although most studies have examined somatic (musculoskeletal and joint) pain, visceral pain (such as headache and abdominal pain) has warranted less attention. We present longitudinal data from age 70 to 90 years concerning chronic musculoskeletal/joint pain, abdominal pain, and headache.
Data was collected by the Jerusalem Longitudinal Study, which is a prospective study of a representative sample from the 1920-1921 birth-cohort living in West Jerusalem. Participants underwent comprehensive assessment at home in 1990, 1998, 2005, and 2010, at ages 70 (n = 460), 78 (n = 763), 85 (n = 1149), and 90 years (n = 394), respectively, and were directly questioned concerning the presence and location of pain.
The overall prevalence of pain of any kind at ages 70, 78, 85, and 90 years was 73% (n = 336/460), 81.1% (n = 619/763), 56.3% (n = 647/1149), and 31.2% (n = 123/394), respectively. Pain at younger ages only was associated with female gender, lower educational status, functional dependence, physical inactivity, increased body mass index, loneliness, depression, and poor self-rated health. At ages 70, 78, 85, and 90 years, chronic neck/back pain was present among 41.5%, 58.9%, 30.1%, and 14.6% of participants, respectively; chronic joint pain was present among 43.0%, 60.6%, 45.2%, and 25.2%, respectively. In contrast abdominal pain was less common and disappeared among the oldest old: 14.7%, 13.9%, 1.7%, and 1.5%, respectively, with a similar pattern for headache: 43.3%, 33.5%, 2.1%, and 1.3%. While pain was reported at ≥2 sites by 42.3% and 54.6% at ages 70 and 78 years, respectively, by ages 85 and 90 years, pain was most frequently reported at only 1 site.
Visceral pain (headache and abdominal pain) completely disappeared among the oldest old, in contrast to a far smaller decline in somatic (musculoskeletal and joint) pain.
随着年龄增长,慢性疼痛的流行病学情况仍未完全明确。尽管大多数研究关注的是躯体(肌肉骨骼和关节)疼痛,但内脏疼痛(如头痛和腹痛)受到的关注较少。我们提供了70至90岁人群关于慢性肌肉骨骼/关节疼痛、腹痛和头痛的纵向数据。
数据由耶路撒冷纵向研究收集,该研究是对居住在耶路撒冷西部的1920 - 1921年出生队列中的代表性样本进行的前瞻性研究。参与者分别在1990年、1998年、2005年和2010年,即70岁(n = 460)、78岁(n = 763)、85岁(n = 1149)和90岁(n = 394)时在家中接受全面评估,并被直接询问疼痛的存在和位置。
70岁、78岁、85岁和90岁时任何类型疼痛的总体患病率分别为73%(n = 336/460)、81.1%(n = 619/763)、56.3%(n = 647/1149)和31.2%(n = 123/394)。仅在年轻时出现疼痛与女性性别、较低的教育程度、功能依赖、身体活动不足、体重指数增加、孤独、抑郁以及自我健康评分差有关。在70岁、78岁、85岁和90岁时,分别有41.5%、58.9%、30.1%和14.6%的参与者存在慢性颈/背痛;慢性关节痛的比例分别为43.0%、60.6%、45.2%和25.2%。相比之下腹痛不太常见,且在最年长者中消失:分别为14.7%、13.9%、1.7%和1.5%,头痛情况类似:分别为43.3%、33.5%、2.1%和1.3%。70岁和78岁时分别有42.3%和54.6%的人报告疼痛发生在≥2个部位,而到85岁和90岁时,最常报告疼痛仅发生在1个部位。
与躯体(肌肉骨骼和关节)疼痛的大幅下降相比,内脏疼痛(头痛和腹痛)在最年长者中完全消失。