Julius Centre, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Population Health and Preventive Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
J Am Geriatr Soc. 2018 Jul;66(6):1165-1171. doi: 10.1111/jgs.15370. Epub 2018 Mar 30.
To examine the cross-sectional and longitudinal relationships between elder abuse and neglect (EAN) and chronic pain in rural older Malaysians.
Two-year prospective cohort study.
Kuala Pilah, a district in Negeri Sembilan approximately 100 km from the capital city, Kuala Lumpur.
Community-dwelling older adults aged 60 and older. Using a multistage cluster sampling strategy, 1,927 respondents were recruited and assessed at baseline, of whom 1,189 were re-assessed 2 years later.
EAN was determined using the modified Conflict Tactic Scale, and chronic pain was assessed through self-report using validated questions.
The prevalence of chronic pain was 20.4%. Cross-sectional results revealed 8 variables significantly associated with chronic pain-age, education, income, comorbidities, self-rated health, depression, gait speed, and EAN. Abused elderly adults were 1.52 times as likely to have chronic pain (odds ratio=1.52, 95% confidence interval (CI)=1.03-2.27), although longitudinal analyses showed no relationship between EAN and risk of chronic pain (risk ratio=1.14, 95% CI=0.81-1.60). This lack of causal link was consistent when comparing analysis with complete cases with that of imputed data.
Our findings indicate no temporal relationship between EAN and chronic pain but indicated cross-sectional associations between the two. This might indicate that, although EAN does not lead to chronic pain, individuals with greater physical limitations are more vulnerable to abuse. Our study also shows the importance of cohort design in determining causal relationships between EAN and potentially linked health outcomes.
研究农村老年马来西亚人虐待和忽视（EAN）与慢性疼痛之间的横断面和纵向关系。
为期两年的前瞻性队列研究。
Kuala Pilah，雪兰莪州一个距离首都吉隆坡约 100 公里的地区。
年龄在 60 岁及以上的社区居住的老年人。使用多阶段聚类抽样策略，招募了 1927 名受访者进行基线评估，其中 1189 名在 2 年后进行了重新评估。
使用改良冲突策略量表确定 EAN，通过使用经过验证的问题进行自我报告来评估慢性疼痛。
慢性疼痛的患病率为 20.4%。横断面结果显示，有 8 个变量与慢性疼痛显著相关-年龄、教育、收入、合并症、自我评估健康、抑郁、步态速度和 EAN。被虐待的老年人患慢性疼痛的可能性是 1.52 倍（优势比=1.52，95%置信区间（CI）=1.03-2.27），尽管纵向分析显示 EAN 与慢性疼痛风险之间没有关系（风险比=1.14，95%CI=0.81-1.60）。当将完整案例的分析与推断数据的分析进行比较时，这种没有因果关系的情况是一致的。
我们的研究结果表明 EAN 与慢性疼痛之间没有时间关系，但表明两者之间存在横断面关联。这可能表明，尽管 EAN 不会导致慢性疼痛，但身体限制较大的个体更容易受到虐待。我们的研究还表明了队列设计在确定 EAN 与潜在相关健康结果之间因果关系的重要性。
