Zimmer Zachary, Rubin Sara
Department of Social and Behavioral Sciences, University of California, San Francisco.
J Gerontol A Biol Sci Med Sci. 2016 Sep;71(9):1171-6. doi: 10.1093/gerona/glw028. Epub 2016 Mar 17.
This study contributes to dialogue on quality versus quantity of life by examining years older persons can expect to live in various states of pain.
Data from seven waves of the Health and Retirement Study; N = 26,896; age 55+. Estimations using the Interpolative Markov Chain approach apply probability transitions to multistate life table functions. Two estimates are interpreted: (i) population-based, which provide population averages aggregated across baseline states and (ii) status-based, which provide independent estimates by baseline state. Age- and sex-specific years with no pain, milder nonlimiting, and severe or limiting pain are reported as is percent of life in states of pain.
Females have higher life expectancy than males but similar expectations of pain-free life. Total life expectancy varies only slightly by baseline pain states but pain-free life expectancy varies greatly. For example, an 85-year-old female pain-free at baseline expects 7.04 more years, 5.28 being pain-free. An 85-year-old female with severe pain at baseline expects 6.42 years with only 2.66 pain-free. Percent of life with pain decreases by age for those pain-free at baseline and increases for those with pain at baseline.
Pain is moderately associated with quantity of or total life but substantially and importantly associated with quality of or pain-free life.
本研究通过考察老年人在不同疼痛状态下的预期存活年数,为关于生活质量与数量的对话做出了贡献。
来自七轮健康与退休研究的数据;N = 26896;年龄55岁及以上。使用内插马尔可夫链方法进行估计,将概率转移应用于多状态生命表函数。解释了两种估计:(i)基于人群的估计,提供跨基线状态汇总的人群平均值;(ii)基于状态的估计,按基线状态提供独立估计。报告了无疼痛、较轻非限制性疼痛以及严重或限制性疼痛的特定年龄和性别的年数,以及处于疼痛状态的生命百分比。
女性的预期寿命高于男性,但无疼痛生活的预期相似。总预期寿命仅因基线疼痛状态略有不同,但无疼痛预期寿命差异很大。例如,一名85岁基线无疼痛的女性预计多活7.04年,其中5.28年无疼痛。一名85岁基线有严重疼痛的女性预计活6.42年,其中仅2.66年无疼痛。对于基线无疼痛的人,有疼痛的生命百分比随年龄下降;对于基线有疼痛的人,有疼痛的生命百分比随年龄上升。
疼痛与总生命数量适度相关,但与无疼痛生活质量显著且重要相关。