Wright Anne R, Shi Xiaoyan A, Busby-Whitehead Jan, Jordan Joanne M, Nelson Amanda E
John A. Burns School of Medicine, Honolulu, HI.
SAS Institute, Cary, NC.
Myopain. 2015;23(1-2):34-44. doi: 10.3109/10582452.2015.1132026. Epub 2016 Feb 17.
Neck and shoulder pain are common but underreported by older people, raising important questions of frequency, medical comorbidities, gender and racial disparities and functional impact associated with neck and shoulder symptoms in elders, which we examined in this analysis.
We performed a cross-sectional analysis in the community-based Johnston County Osteoarthritis Project, a cohort that is representative of the U.S. population, utilizing data from 1672 participants with a mean age of 68 years; 69% were white and 68% were women. Trained staff obtained data on participant-reported: symptoms, comorbidities, depression, and functional status; and performance-based functional assessments. Regression models of neck and shoulder symptoms and functional measures were adjusted for age, sex, race, and body mass index, and additionally for other joint symptoms and comorbidities.
Symptoms of neck (8%), shoulder (13%) or both (13%) were reported by participants. Neck symptoms were most frequently reported by White women; shoulder symptoms were evenly distributed among race and gender subgroups. Neck and shoulder symptoms were associated with cancer, diabetes mellitus, depression, and lung, cardiovascular, and other musculoskeletal problems, as well as pain, aching or stiffness at other sites, and independently with self-reported and performance -based functional measures.
These findings suggest that primary health care providers should inquire about neck and shoulder symptoms and address potential underlying causes to improve functional status and decrease disability in older people.
颈部和肩部疼痛很常见,但老年人对此报告不足,这引发了关于老年人颈部和肩部症状的频率、合并症、性别和种族差异以及功能影响等重要问题,我们在本分析中对这些问题进行了研究。
我们在基于社区的约翰斯顿县骨关节炎项目中进行了横断面分析,该队列代表了美国人群,利用了1672名平均年龄为68岁的参与者的数据;69%为白人,68%为女性。经过培训的工作人员获取了参与者报告的数据:症状、合并症、抑郁症和功能状态;以及基于表现的功能评估。颈部和肩部症状以及功能指标的回归模型针对年龄、性别、种族和体重指数进行了调整,此外还针对其他关节症状和合并症进行了调整。
参与者报告了颈部(8%)、肩部(13%)或两者(13%)的症状。白人女性最常报告颈部症状;肩部症状在种族和性别亚组中分布均匀。颈部和肩部症状与癌症、糖尿病、抑郁症以及肺部、心血管和其他肌肉骨骼问题相关,也与其他部位的疼痛、酸痛或僵硬相关,并且独立于自我报告和基于表现的功能指标。
这些发现表明,初级医疗保健提供者应询问颈部和肩部症状,并解决潜在的根本原因,以改善老年人的功能状态并减少残疾。