Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA.
Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
Eur J Pain. 2021 May;25(5):1041-1052. doi: 10.1002/ejp.1725. Epub 2021 Jan 24.
Chronic pain is associated with significant physical and psychological impairments across the adult lifespan. However, there is a relative gap in knowledge on individual differences that predict pain-related functioning. The current study highlights one important source of individual variation: age.
We used cross-sectional data from a large treatment-seeking cohort of 2,905 adults (M age = 46.6 [13.1]; 71.8% women) presenting to a tertiary pain centre in the United Kingdom to determine age differences in cognitive-affective processes (catastrophizing, acceptance, self-efficacy), including their differential patterns and effects on disability and depression.
Older adults (ages 65-75) were found to experience higher pain acceptance and pain self-efficacy compared to both middle-aged (ages 40-64) and young adult (ages 18-39) age groups. Older adults also experienced lower levels of catasophizing compared to middle-age adults. Testing age as a moderator, we found that the relationships of pain self-efficacy and acceptance with depression as well as the relationship between pain self-efficacy and disability were comparatively weakest among older adults and strongest among young adults. Similarly, the relationship between pain catastrophizing and depression was relatively stronger for young and middle-aged adults compared to older adults.
Age-related differences in psychological mechanisms that influence pain-related functioning present unique challenges and opportunities for scientists and clinicians to improve our understanding and treatment of pain across the lifespan. Additional work is needed to refine our knowledge of age-related differences in cognitive-affective, biopsychosocial dimensions of chronic pain and to develop and test the efficacy of age-tailored interventions.
Our cross-sectional analysis of 2,905 treatment-seeking adults with chronic pain presenting to a tertiary care center in the United Kingdom revealed distinct age differences in cognitive-affective linked to disability and depression. This study contributes to the limited knowledge on age-related variance in psychological mechanisms underlying adjustment to chronic pain. Promising avenues for future research include refining our understanding of age-related differences in cognitive-affective, biopsychosocial dimensions of chronic pain and elucidating the most salient treatment targets among different age groups.
慢性疼痛会对整个成年期的身体和心理健康造成严重损害。然而，对于能够预测疼痛相关功能的个体差异，我们的了解还相对有限。本研究强调了一个重要的个体差异来源：年龄。
我们使用了来自英国一家三级疼痛中心的一个大型治疗性成人队列的横断面数据（M 年龄=46.6[13.1]；71.8%为女性），以确定认知情感过程（灾难化、接受、自我效能）中的年龄差异，包括它们对残疾和抑郁的不同模式和影响。
与中年（40-64 岁）和青年（18-39 岁）年龄组相比，老年（65-75 岁）组的疼痛接受度和自我效能感更高。与中年成年人相比，老年成年人的灾难化程度也更低。通过检验年龄作为调节变量，我们发现疼痛自我效能感和接受度与抑郁的关系，以及疼痛自我效能感与残疾的关系，在老年成年人中相对较弱，在青年成年人中相对较强。同样，与老年成年人相比，年轻和中年成年人的疼痛灾难化与抑郁的关系相对较强。
影响疼痛相关功能的心理机制的年龄相关差异为科学家和临床医生提供了独特的挑战和机遇，以提高我们对整个生命周期疼痛的理解和治疗。需要进一步的工作来完善我们对慢性疼痛的认知情感、生物心理社会维度的年龄相关差异的认识，并开发和测试针对年龄的干预措施的疗效。
我们对英国一家三级护理中心就诊的 2905 名慢性疼痛治疗性成年人的横断面分析显示，认知情感与残疾和抑郁相关的调节存在明显的年龄差异。这项研究有助于了解与慢性疼痛适应相关的心理机制的年龄相关差异方面的知识有限。未来研究的有前景的方向包括完善我们对慢性疼痛的认知情感、生物心理社会维度的年龄相关差异的认识，并阐明不同年龄组中最显著的治疗目标。
