Veronese Nicola, Maggi Stefania, Trevisan Caterina, Noale Marianna, De Rui Marina, Bolzetta Francesco, Zambon Sabina, Musacchio Estella, Sartori Leonardo, Perissinotto Egle, Stubbs Brendon, Crepaldi Gaetano, Manzato Enzo, Sergi Giuseppe
Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy.
National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.
Pain Med. 2017 Mar 1;18(3):414-427. doi: 10.1093/pm/pnw163.
While osteoarthritis (OA)-related pain increases the risk of physical inactivity, disability, and falls, less is known about whether pain increases the risk of frailty. We investigated if people with OA reporting pain are more likely to develop frailty than people with OA without pain.
Population-based prospective cohort study with a follow-up of 4.4 years.
Community.
The subjects were 1,775 older men and women with osteoarthritis, enrolled in the Progetto Veneto Anziani.
Pain was ascertained according to medical records, symptoms/signs, and use of analgesics. Participants were considered frail if they met three out of five criteria of Fried's Index.
Cross-sectional analysis at baseline demonstrated that after adjusting for potential confounders (age, gender, anthropometric and demographic data, comorbidities), people with OA and pain (n = 568) were significantly more likely to have frailty compared with those with OA without pain (n = 1,207; hand OA, OR = 1.86, 95% CI = 1.65-2.09; hip OA, OR = 1.62, 95% CI = 1.44-1.83; knee OA, OR = 1.42, 95% CI = 1.26-1.60; all p < 0.0001). Prospective analysis of 1,152 nonfrail subjects at baseline demonstrated that 19.9% developed incident frailty. A fully-adjusted logistic regression analysis demonstrated that lower limb OA-related pain was associated with an increased risk of developing frailty compared with people with OA and no pain.
Pain related to OA might be an important factor influencing the relationship between OA and the development of frailty.
虽然骨关节炎（OA）相关疼痛会增加身体活动不足、残疾和跌倒的风险，但关于疼痛是否会增加衰弱风险的了解较少。我们调查了报告有疼痛的OA患者是否比无疼痛的OA患者更易发生衰弱。
基于人群的前瞻性队列研究，随访4.4年。
社区。
研究对象为1775名患有骨关节炎的老年男性和女性，他们参加了威尼托老年人项目。
根据病历、症状/体征和镇痛药使用情况确定疼痛。如果参与者符合Fried指数五项标准中的三项，则被视为衰弱。
基线时的横断面分析表明，在调整潜在混杂因素（年龄、性别、人体测量和人口统计学数据、合并症）后，与无疼痛的OA患者（n = 1207）相比，有疼痛的OA患者（n = 568）发生衰弱的可能性显著更高（手部OA，OR = 1.86，95%CI = 1.65 - 2.09；髋部OA，OR = 1.62，95%CI = 1.44 - 1.83；膝部OA，OR = 1.42，95%CI = 1.26 - 1.60；所有p < 0.0001）。对基线时1152名非衰弱受试者的前瞻性分析表明，19.9%的人发生了新发衰弱。一项完全调整的逻辑回归分析表明，与无疼痛的OA患者相比，下肢OA相关疼痛与发生衰弱的风险增加有关。
与OA相关的疼痛可能是影响OA与衰弱发生之间关系的一个重要因素。
