School of Kinesiology and Health Science.
Department of Supportive Care.
Pain Med. 2018 Apr 1;19(4):658-676. doi: 10.1093/pm/pnx002.
Age-related patterns in cancer pain remain equivocal. Most studies ignore heterogeneity across multiple domains of well-being, and the potential role of physical (PH) and mental health (MH) quality of life (QOL) in these age-related patterns is unknown. We investigated the relationships between age and cancer pain intensity, qualities, and interference, and physical and psychosocial adaptation and the interaction between age and PH and MH QOL on pain and adaptation to cancer pain.
In this cross-sectional study, 244 patients with advanced cancer and pain completed measures of pain, QOL, physical function, and psychosocial well-being. Pearson's correlations and ANOVAs assessed relationships between age and demographic and clinical factors, pain, and physical and psychosocial measures. Regression models tested the role of age and its interaction with PH and MH QOL on pain and physical and psychosocial adaptation.
Older age was associated with a lower likelihood of receiving an opioid prescription, greater likelihood of having comorbidities, and worse functional status. When we did not account for these factors, age was not associated with pain and most adaptation indices. When we did account for these factors and PH QOL, older age was associated with lower non-neuropathic and neuropathic pain and several indices of psychosocial adaptation. Most interestingly, older age was associated with lower non-neuropathic pain among those with high, but not low, MH QOL.
This study addresses knowledge gaps about factors underlying age-related patterns in cancer pain. Impaired MH QOL may be a proxy for age-related patterns in cancer pain.
This study investigated age-related patterns in the experience of cancer pain and the role of quality of life in resilience and vulnerability to pain and adaptation to pain. Older age is associated with lower non-neuropathic pain among those with high, but not low, mental health quality of life, suggesting that impaired mental health quality of life is an important indicator of vulnerability to multidimensional pain outcomes.
癌症疼痛与年龄相关的模式仍存在争议。大多数研究忽略了幸福感的多个领域的异质性，以及身体（PH）和心理健康（MH）生活质量（QOL）在这些与年龄相关的模式中的潜在作用尚不清楚。我们研究了年龄与癌症疼痛强度、质量和干扰以及身体和心理社会适应之间的关系，以及 PH 和 MH QOL 对疼痛和适应癌症疼痛的相互作用。
在这项横断面研究中，244 名晚期癌症和疼痛患者完成了疼痛、QOL、身体功能和心理社会健康状况的测量。Pearson 相关系数和方差分析评估了年龄与人口统计学和临床因素、疼痛以及身体和心理社会测量之间的关系。回归模型测试了年龄及其与 PH 和 MH QOL 的相互作用对疼痛和身体及心理社会适应的作用。
年龄较大与接受阿片类药物处方的可能性降低、合并症的可能性增加以及功能状态较差相关。当我们不考虑这些因素时，年龄与疼痛和大多数适应指数无关。当我们考虑到这些因素和 PH QOL 时，年龄较大与较低的非神经性和神经性疼痛以及心理社会适应的几个指数相关。最有趣的是，在 MH QOL 较高而非较低的情况下，年龄较大与较低的非神经性疼痛相关。
本研究解决了癌症疼痛与年龄相关模式的潜在因素方面的知识空白。MH QOL 受损可能是癌症疼痛与年龄相关模式的替代指标。
本研究调查了癌症疼痛体验中与年龄相关的模式以及生活质量在对疼痛的弹性和脆弱性以及对疼痛的适应中的作用。在 MH QOL 较高而非较低的情况下，年龄较大与较低的非神经性疼痛相关，这表明 MH QOL 受损是对多维疼痛结果的脆弱性的重要指标。
