患有慢性腰痛的老年人在基线特征和预后方面与年轻人有差异吗？

Do older adults with chronic low back pain differ from younger adults in regards to baseline characteristics and prognosis?

作者信息

Manogharan S, Kongsted A, Ferreira M L, Hancock M J

机构信息

Faculty of Medicine and Health Science, Macquarie University, Sydney, NSW, Australia.

Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.

出版信息

Eur J Pain. 2017 May;21(5):866-873. doi: 10.1002/ejp.989. Epub 2017 Mar 14.

DOI:10.1002/ejp.989

PMID:28295893

Abstract

BACKGROUND

Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP, in terms of their baseline characteristics, and pain and disability outcomes over 1 year.

METHODS

Data were systematically collected as part of routine care in a secondary care spine clinic. At initial presentation patients answered a self-report questionnaire and underwent a physical examination. Patients older than 65 were classified as older adults and compared to middle aged (45-65 years old) and younger adults (17-44 years old) for 10 baseline characteristics. Pain intensity and disability were collected at 6 and 12 month follow-ups and compared between age groups.

RESULTS

A total of 14,479 participants were included in the study. Of these 3087 (21%) patients were older adults, 6071 (42%) were middle aged and 5321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain, more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups.

CONCLUSIONS

This study found small baseline differences in older people with chronic LBP compared to middle aged and younger adults. There were no associations between age groups and the clinical course.

SIGNIFICANCE

Small baseline differences exist in older people with chronic low back pain compared to middle aged and younger adults referred to secondary care for chronic low back pain. Older adults present with slightly less intense low back pain but slightly more intense leg pain. Changes in pain intensity and disability over a 12 month period were similar across all age groups.

摘要

背景

由于绝大多数腰痛（LBP）研究都集中在劳动年龄人口，老年人的腰痛情况鲜为人知。本研究的目的是比较患有慢性腰痛的老年人与患有慢性腰痛的中青年成年人在基线特征、疼痛及1年期间的残疾结局方面的差异。

方法

作为二级护理脊柱诊所常规护理的一部分，系统收集数据。初次就诊时，患者需回答一份自我报告问卷并接受体格检查。65岁以上的患者被归类为老年人，并与中年（45 - 65岁）和青年成年人（17 - 44岁）在10项基线特征方面进行比较。在6个月和12个月随访时收集疼痛强度和残疾情况，并在各年龄组之间进行比较。

结果

本研究共纳入14479名参与者。其中，3087名（21%）患者为老年人，6071名（42%）为中年人，5321名（37%）为青年人。就诊时，在大多数测量特征方面，老年人与中年人和青年人在统计学上存在差异（例如，腰痛较轻、腿痛较多、抑郁较多）；然而，差异较小。各年龄组在12个月内疼痛和残疾的变化并无差异。