Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.
J Headache Pain. 2020 May 6;21(1):45. doi: 10.1186/s10194-020-01116-3.
Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents.
We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors.
A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years' follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80).
Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese.
疼痛是一种常见症状,常与神经和肌肉骨骼疾病有关,尤其在女性和老年人中更为常见,且在一般人群中呈上升趋势。已经确定了不同的疼痛风险因素,但通常来自样本有限且候选预测因子数量有限的研究。本研究旨在从大量变量和受访者中评估疼痛的预测因素。
我们使用 ATHLOS 项目的部分协调数据集,选择具有纵向过程的研究和波次,其中基线时无疼痛且随访时无缺失。根据缺失分布和与疼痛的单变量关联选择预测因子,并从以下领域中选择:社会人口学和经济特征、生活方式和健康行为、健康状况和功能限制、疾病、身体测量、认知、个性和其他心理测量以及社会环境。然后应用分层逻辑回归模型来确定显著的预测因素。
共纳入 13545 名受试者,其中 5348 名(39.5%)在基线至平均 5.2 年随访期间出现疼痛。疼痛的基线风险因素为女性(OR 1.34)、剧烈运动(OR 2.51)、肥胖(OR 1.36)和失去亲密的人(OR 1.88),而随访风险因素为低能量/疲劳(1.93)、行走困难(1.69)、自我评估健康状况较差(OR 2.20)或一般到中度(OR 1.57)和存在睡眠问题(1.80)。
我们的研究结果显示,在五年的随访期间,39.5%的受访者出现疼痛,疼痛存在近端和远端风险因素,其中一部分是可以直接改变的。改善睡眠、减少肥胖人群的体重和治疗疲劳等行动将对疼痛发作产生积极影响,并且应建议 60 岁或以上的人避免剧烈运动,特别是如果是女性或肥胖者。