Wade Katie Fredrika, Lee David M, McBeth John, Ravindrarajah Rathi, Gielen Evelien, Pye Stephen R, Vanderschueren Dirk, Pendleton Neil, Finn Joseph D, Bartfai György, Casanueva Felipe F, Forti Gianni, Giwercman Aleksander, Huhtaniemi Ilpo T, Kula Krzysztof, Punab Margus, Wu Frederick C W, O'Neill Terence W
Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust-Manchester Academic Health Science Centre, Manchester, UK.
Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, UK.
Age Ageing. 2016 Mar;45(2):268-74. doi: 10.1093/ageing/afv170. Epub 2015 Dec 17.
we hypothesised that chronic widespread pain (CWP), by acting as a potential stressor, may predispose to the development of, or worsening, frailty.
longitudinal analysis within the European Male Ageing Study (EMAS).
a total of 2,736 community-dwelling men aged 40-79.
subjects completed a pain questionnaire and shaded a manikin, with the presence of CWP defined using the American College of Rheumatology criteria. Physical activity, smoking, alcohol consumption and depression were measured. Repeat assessments took place a median of 4.3 years later. A frailty index (FI) was used, with frail defined as an FI >0.35. The association between CWP at baseline and the new occurrence of frailty was examined using logistic regression; the association between CWP at baseline and change in FI was examined using negative binomial regression.
at baseline, 218 (8.3%) men reported CWP. Of the 2,631 men who were defined as non-frail at baseline, 112 (4.3%) were frail at follow-up; their mean FI was 0.12 (SD 0.1) at baseline and 0.15 (SD 0.1) at follow-up, with a mean change of 0.03 (SD 0.08) P ≤ 0.001. Among men who were non-frail at baseline, those with CWP were significantly more likely to develop frailty. After adjustment for age and centre, compared with those with no pain, those with CWP at baseline had a 70% higher FI at follow-up; these associations remained significant after further adjustment for smoking, body mass index, depression, physical activity and FI at baseline.
the presence of CWP is associated with an increased risk of frailty in older European men.
我们假设慢性广泛性疼痛（CWP）作为一种潜在的应激源，可能会诱发衰弱或使其恶化。
欧洲男性衰老研究（EMAS）中的纵向分析。
共有2736名年龄在40 - 79岁的社区男性。
受试者完成一份疼痛问卷并在人体模型上标记，根据美国风湿病学会标准定义是否存在CWP。测量身体活动、吸烟、饮酒和抑郁情况。在中位数为4.3年后进行重复评估。使用衰弱指数（FI），将衰弱定义为FI>0.35。使用逻辑回归检验基线时的CWP与新出现的衰弱之间的关联；使用负二项回归检验基线时的CWP与FI变化之间的关联。
在基线时，218名（8.3%）男性报告有CWP。在基线时被定义为非衰弱的2631名男性中，112名（4.3%）在随访时衰弱；他们的平均FI在基线时为0.12（标准差0.1），在随访时为0.15（标准差0.1），平均变化为0.03（标准差0.08），P≤0.001。在基线时非衰弱的男性中，有CWP的男性更有可能发展为衰弱。在调整年龄和中心因素后，与无疼痛的男性相比，基线时有CWP的男性在随访时的FI高70%；在进一步调整吸烟、体重指数、抑郁、身体活动和基线时的FI后，这些关联仍然显著。
CWP的存在与老年欧洲男性衰弱风险增加有关。
