Smith Toby O, Dainty Jack R, Williamson Esther, Martin Kathryn R
Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK.
Norwich Medical School, University of East Anglia, Norwich, UK.
Br J Pain. 2019 May;13(2):82-90. doi: 10.1177/2049463718802868. Epub 2018 Sep 20.
Musculoskeletal pain is a prevalent health challenge for all age groups worldwide, but most notably in older adults. Social isolation is the consequence of a decrease in social network size with a reduction in the number of social contacts. Loneliness is the psychological embodiment of social isolation and represents an individual's perception of dissatisfaction in the quality or quantity of their social contacts. This study aims to determine whether a relationship exists between musculoskeletal pain and social isolation and loneliness.
A cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA) cohort was undertaken. ELSA is a nationally representative sample of the non-institutionalised population of individuals aged 50 years and over based in England. Data were gathered on social isolation through the ELSA Social Isolation Index, loneliness through the University of California, Los Angeles (UCLA) Loneliness Scale and musculoskeletal pain. Data for covariates included physical activity, depression score, socioeconomic status, access to transport and demographic characteristics. Logistic regression analyses were undertaken to determine the relationship between social isolation and loneliness with pain and the additional covariates.
A total of 9299 participants were included in the analysis. This included 4125 (44.4%) males, with a mean age of 65.8 years. There was a significant association where social isolation was lower for those in pain (odd ratio (OR): 0.87; 95% confidence intervals (CI): 0.75 to 0.99), whereas the converse occurred for loneliness where this was higher for those in pain (OR: 1.15; 95% CI: 1.01 to 1.31). Age, occupation, physical activity and depression were all associated with increased social isolation and loneliness.
People who experience chronic musculoskeletal pain are at greater risk of being lonely, but at less risk of being socially isolated. Health professionals should consider the wider implications of musculoskeletal pain on individuals, to reduce the risk of negative health implications associated with loneliness from impacting on individual's health and well-being.
肌肉骨骼疼痛是全球所有年龄组面临的普遍健康挑战,在老年人中尤为明显。社会隔离是社交网络规模缩小和社交接触次数减少的结果。孤独是社会隔离的心理体现,代表个人对其社交接触的质量或数量不满意的认知。本研究旨在确定肌肉骨骼疼痛与社会隔离和孤独之间是否存在关联。
对英国老龄化纵向研究(ELSA)队列进行横断面分析。ELSA是英国50岁及以上非机构化人口的全国代表性样本。通过ELSA社会隔离指数收集社会隔离数据,通过加利福尼亚大学洛杉矶分校(UCLA)孤独量表收集孤独数据以及肌肉骨骼疼痛数据。协变量数据包括身体活动、抑郁评分、社会经济地位、交通便利性和人口统计学特征。进行逻辑回归分析以确定社会隔离和孤独与疼痛及其他协变量之间的关系。
共有9299名参与者纳入分析。其中包括4125名(44.4%)男性,平均年龄为65.8岁。存在显著关联,疼痛者的社会隔离程度较低(比值比(OR):0.87;95%置信区间(CI):0.75至0.99),而孤独情况则相反,疼痛者的孤独感更高(OR:1.15;95%CI:1.01至1.31)。年龄、职业、身体活动和抑郁都与社会隔离和孤独感增加有关。
经历慢性肌肉骨骼疼痛的人孤独风险更高,但社会隔离风险较低。卫生专业人员应考虑肌肉骨骼疼痛对个体的更广泛影响,以降低与孤独相关的负面健康影响对个体健康和幸福的影响风险。