Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.
Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.
Int J Environ Res Public Health. 2019 Nov 20;16(23):4598. doi: 10.3390/ijerph16234598.
Few studies have focused on a relationship between the built environment and musculoskeletal pain. This study aimed to investigate an association between neighborhood walkability and knee and low back pain in older people. Data were derived from the Japan Gerontological Evaluation Study (JAGES) 2013, a population-based study of independently living people ≥65 years old. A cross-sectional multilevel analysis was performed, of 22,892 participants in 792 neighborhoods. Neighborhood walkability was assessed by residents' perceptions and population density. Dependent variables were knee and low back pain restricting daily activities within the past year. The prevalence of knee pain was 26.2% and of low back pain 29.3%. After adjusting for sociodemographic covariates, the prevalence ratio (PR) of knee and low back pain was significantly lower in neighborhoods with better access to parks and sidewalks, good access to fresh food stores, and higher population densities. After additionally adjusting for population density, easier walking in neighborhoods without slopes or stairs was significantly inversely correlated with knee pain (PR 0.91, 95% confidence interval 0.85-0.99). Neighborhoods with walkability enhanced by good access to parks and sidewalks and fresh food stores, easy walking without slopes or stairs, and high population densities, had lower prevalences of knee and low back pain among older people. Further studies should examine environmental determinants of pain.
很少有研究关注建筑环境与肌肉骨骼疼痛之间的关系。本研究旨在调查老年人邻里步行便利性与膝关节和下背痛之间的关联。数据来自日本老年评估研究（JAGES）2013 年，这是一项针对 65 岁及以上独立生活人群的基于人群的研究。对 792 个街区的 22892 名参与者进行了横断面多层次分析。邻里步行便利性由居民的感知和人口密度来评估。因变量是过去一年中限制日常活动的膝关节和下背痛。膝关节疼痛的患病率为 26.2%，下背痛的患病率为 29.3%。在调整了社会人口学协变量后，公园和人行道可达性更好、新鲜食品店可达性更好、人口密度更高的街区的膝关节和下背痛患病率显著较低。在进一步调整了人口密度后，没有坡度或楼梯的街区更容易行走与膝关节疼痛呈显著负相关（PR 0.91，95%置信区间 0.85-0.99）。邻里步行便利性通过更好地接近公园和人行道以及新鲜食品店、没有坡度或楼梯的轻松行走以及较高的人口密度得到增强，可降低老年人膝关节和下背痛的患病率。进一步的研究应该研究疼痛的环境决定因素。
