O'Donnell Siobhan, Rusu Corneliu, Hawker Gillian A, Bernatsky Sasha, McRae Louise, Canizares Mayilee, MacKay Crystal, Badley Elizabeth M
Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, ON, Canada.
Department of Medicine, University of Toronto School of Medicine, Toronto, ON, Canada.
BMC Musculoskelet Disord. 2015 Aug 30;16:230. doi: 10.1186/s12891-015-0691-2.
There is a perception that the impacts of arthritis are greatest among older adults. However, the effect of age on health-related outcomes in individuals with arthritis has not been explicitly studied. This study examined whether the physical and mental health impacts of arthritis are greater in older (75+ years) versus younger (20-44, 45-64 and 65-74 years) Canadian adults.
Data were from the arthritis component of the 2009 Survey on Living with Chronic Diseases in Canada. The responses were weighted to be representative of Canadians (≥20 years) with arthritis. Associations between age and the prevalence of severe/frequent joint pain, severe/frequent fatigue, sleep limitations, instrumental activities of daily living (IADLs) limitations, high levels of stress, suboptimal general and suboptimal mental health, were examined descriptively prior to conducting multivariate log-binomial regression analyses.
A total of 4565 respondents completed the survey (78% response rate). Individuals with arthritis were mostly female (63%), of working age (57%) and overweight or obese (67%). Upon adjusting for covariates, younger (20-44 years) and/or middle aged (45-64 years) adults were more likely than those older (75+ years) to report severe/frequent joint pain, sleep limitations, high levels of stress and suboptimal mental health. After adjusting for covariates, age was not associated with IADL limitations, severe/frequent fatigue or suboptimal general health.
Contrary to the belief that older adults with arthritis experience more severe physical and mental health outcomes, we found that older adults were less likely to report worse outcomes than younger adults. In light of these findings, public health messaging should stress that arthritis does not just affect the elderly and emphasize the importance of timely diagnosis and management at all ages in order to prevent or, minimize arthritis-related impairment.
人们认为关节炎对老年人的影响最大。然而，年龄对关节炎患者健康相关结局的影响尚未得到明确研究。本研究调查了在加拿大成年人中，年龄较大（75岁及以上）与年龄较小（20 - 44岁、45 - 64岁和65 - 74岁）的关节炎患者相比，关节炎对其身心健康的影响是否更大。
数据来自2009年加拿大慢性病生活状况调查中的关节炎部分。对回答进行加权处理，以代表加拿大（≥20岁）患有关节炎的人群。在进行多变量对数二项回归分析之前，先对年龄与严重/频繁关节疼痛、严重/频繁疲劳、睡眠受限、日常生活工具性活动（IADL）受限、高压力水平、一般健康状况不佳和心理健康状况不佳的患病率之间的关联进行描述性研究。
共有4565名受访者完成了调查（回复率为78%）。患有关节炎的个体大多为女性（63%），处于工作年龄（57%），超重或肥胖（67%）。在对协变量进行调整后，年龄较小（20 - 44岁）和/或中年（45 - 64岁）的成年人比年龄较大（75岁及以上）的成年人更有可能报告严重/频繁关节疼痛、睡眠受限、高压力水平和心理健康状况不佳。在对协变量进行调整后，年龄与IADL受限、严重/频繁疲劳或一般健康状况不佳无关。
与认为患有关节炎的老年人身心健康结局更严重的观点相反，我们发现老年人报告较差结局的可能性低于年轻人。鉴于这些发现，公共卫生宣传应强调关节炎不仅影响老年人，并强调在所有年龄段及时诊断和管理的重要性，以预防或尽量减少与关节炎相关的损害。
