Mallon Tina, Ernst Annette, Brettschneider Christian, König Hans-Helmut, Luck Tobias, Röhr Susanne, Weyerer Siegfried, Werle Jochen, Mösch Edelgard, Weeg Dagmar, Fuchs Angela, Pentzek Michael, Kleineidam Luca, Heser Kathrin, Riedel-Heller Steffi, Maier Wolfgang, Wiese Birgitt, Scherer Martin
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMC Fam Pract. 2018 Jun 9;19(1):85. doi: 10.1186/s12875-018-0768-8.
The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact on the prevalence of pain and everyday life.
Participants from the German longitudinal cohort study on Needs, Health Service Use, Costs and Health-related Quality of Life in a large Sample of Oldest-old Primary Care Patients (85+) (AgeQualiDe) were asked to rate their severity of pain as well as the impairment with daily activities. Besides gender, age, education, BMI and use of analgesics we focused on the current housing situation and on cognitive state. Associations of the dependent measures were tested using four ordinal logistic regression models. Model 1 and 4 consisted of the overall sample, model 2 and 3 were divided according to no cognitive impairment (NCI) and mild cognitive impairment (MCI).
Results show a decline in pain at very old age but nonetheless a high prevalence among the 85+ year olds. Sixty-three per cent of the participants report mild to severe pain and 69% of the participants mild to extreme impairment due to pain with daily activities. Use of analgesics, depression and living at home with care support are significantly associated with higher and male gender with lower pain ratings.
Sufficient pain management among the oldest age group is inevitable. Outpatient care settings are at risk of overlooking pain. Therefore focus should be set on pain management in these settings.
疼痛在最年长的年龄组中非常普遍。成功管理疼痛是初级保健中的一个关键话题,尤其是在老年人群体中。不同的护理环境可能会对疼痛的发生率和日常生活产生影响。
来自德国一项关于最年长的初级保健患者(85岁以上)的需求、医疗服务使用、成本和健康相关生活质量的纵向队列研究(AgeQualiDe)的参与者被要求对他们的疼痛严重程度以及日常活动的受损情况进行评分。除了性别、年龄、教育程度、体重指数和镇痛药的使用外,我们还关注当前的居住状况和认知状态。使用四个有序逻辑回归模型测试相关的因变量。模型1和4由总体样本组成,模型2和3根据无认知障碍(NCI)和轻度认知障碍(MCI)进行划分。
结果显示,在非常高龄时疼痛有所下降,但85岁以上人群中的患病率仍然很高。63%的参与者报告有轻度至重度疼痛,69%的参与者因疼痛而在日常活动中存在轻度至重度受损。使用镇痛药、抑郁以及在有护理支持的情况下居家生活与较高的疼痛评分显著相关,而男性的疼痛评分较低。
在最年长的年龄组中进行充分的疼痛管理是不可避免的。门诊护理环境有忽视疼痛的风险。因此,应将重点放在这些环境中的疼痛管理上。