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腰痛与虚弱密切相关,但与肌肉减少症无关:日本农村社区居住的老年成年人的横断面研究。

Low back pain is closely associated with frailty but not with sarcopenia: Cross-sectional study of rural Japanese community-dwelling older adults.

机构信息

Department of Orthopedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan.

Department of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

Geriatr Gerontol Int. 2021 Jan;21(1):54-59. doi: 10.1111/ggi.14100. Epub 2020 Nov 27.

Abstract

AIM

We speculated that low back pain, which is the most common ailment in older adults, is associated with frailty and/or sarcopenia and contributes to the progression of either condition. Our objective was to evaluate the relationship between low back pain, sarcopenia and frailty in rural Japanese community-dwelling older adults.

METHODS

We recruited 730 participants aged ≥65 years who underwent a comprehensive health examination between November 2016 and December 2018. The Oswestry Disability Index (ODI) was used to assess low back pain quantitatively, and scores were compared for the frail groups determined by the Japanese version of Cardiovascular Health Study, and the sarcopenia groups as determined by the Asian Working Group for Sarcopenia 2019.

RESULTS

Among 730 participants, the prevalence of low back pain was 57.8%. There were significant differences in the ODI scores between the robust, prefrail and frail groups (P < 0.001). In contrast, there were no significant differences in the ODI scores among the robust, low appendicular skeletal muscle and sarcopenia groups. Logistic regression analysis showed that the prevalence of low back pain and the ODI scores were significantly associated with frailty after adjustment for age, sex and body mass index (odds ratio 3.41, 95% confidence interval 1.39-8.39, P = 0.008, and odds ratio 1.06, 95% confidence interval 1.04-1.09, P < 0.001, respectively).

CONCLUSIONS

To the best of our knowledge, this study is the first to show the close association between low back pain and frailty, and suggests that not only the decline in physical function but also neuropsychiatric factors, including chronic pain, constitute a vicious cycle of frailty in community-dwelling older adults. Geriatr Gerontol Int 2021; 21: 54-59.

摘要

目的

我们推测,腰痛是老年人最常见的疾病,与虚弱和/或肌肉减少症有关,并导致这两种疾病的进展。我们的目的是评估日本农村社区居住的老年人腰痛、肌肉减少症和虚弱之间的关系。

方法

我们招募了 730 名年龄≥65 岁的参与者,他们在 2016 年 11 月至 2018 年 12 月期间接受了全面健康检查。使用 Oswestry 残疾指数(ODI)对腰痛进行定量评估,并比较了由日本心血管健康研究版本确定的虚弱组和由 2019 年亚洲肌肉减少症工作组确定的肌肉减少症组的分数。

结果

在 730 名参与者中,腰痛的患病率为 57.8%。在 ODI 评分方面,在强壮、衰弱前期和衰弱组之间存在显著差异(P<0.001)。相比之下,在强壮、低四肢骨骼肌和肌肉减少症组之间,ODI 评分没有显著差异。Logistic 回归分析显示,在调整年龄、性别和体重指数后,腰痛的患病率和 ODI 评分与虚弱显著相关(比值比 3.41,95%置信区间 1.39-8.39,P=0.008,比值比 1.06,95%置信区间 1.04-1.09,P<0.001)。

结论

据我们所知,这项研究首次表明腰痛与虚弱之间存在密切关联,并表明不仅身体功能下降,而且包括慢性疼痛在内的神经精神因素,构成了社区居住的老年人虚弱的恶性循环。老年医学与老年病学杂志 2021; 21: 54-59。

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