Powell Victoria D, Abedini Nauzley C, Galecki Andrzej T, Kabeto Mohammed, Kumar Navasuja, Silveira Maria J
Veterans Affairs Ann Arbor Geriatric Research, Education, and Clinical Center, MI, USA.
University of Michigan, Ann Arbor, USA.
Gerontol Geriatr Med. 2021 Feb 23;7:2333721421997620. doi: 10.1177/2333721421997620. eCollection 2021 Jan-Dec.
Pain, fatigue, and depression commonly co-occur as a symptom cluster in pathological inflammatory states. Psychosocial stressors such as loneliness may lead to similar states through shared mechanisms. We investigated the association of loneliness with pain, fatigue, and depression in older adults. Using Health and Retirement Study data ( = 11,766), we measured cross-sectional prevalence of frequent, moderate to severe pain; severe fatigue; depressive symptoms; and co-occurrence of symptoms surpassing threshold levels (i.e., symptom cluster). Logistic regression models evaluated associations with loneliness. Pain, fatigue, and depression were reported in 19.2%, 20.0%, and 15.3% of the total sample, respectively. The symptom cluster was seen in 4.9% overall; prevalence in lonely individuals was significantly increased (11.6% vs. 2.3%, < .0001). After adjusting for demographic variables, loneliness associated with the symptom cluster (adjusted OR = 3.39, 95% CI = 2.91, 3.95) and each symptom (pain adjusted OR = 1.61, 95% CI = 1.48, 1.76; fatigue adjusted OR = 2.02, 95% CI = 1.85, 2.20; depression adjusted OR = 4.34, 95% CI = 3.93, 4.79). Loneliness strongly associates with the symptom cluster of pain, fatigue, and depression. Further research should examine causal relationships and investigate whether interventions targeting loneliness mitigate pain, fatigue, and depression.
在病理性炎症状态下，疼痛、疲劳和抑郁通常作为一组症状共同出现。诸如孤独等社会心理压力源可能通过共同机制导致类似状态。我们调查了老年人孤独感与疼痛、疲劳和抑郁之间的关联。利用健康与退休研究数据（n = 11766），我们测量了频繁的中度至重度疼痛、严重疲劳、抑郁症状的横断面患病率，以及超过阈值水平的症状共同出现情况（即症状群）。逻辑回归模型评估了与孤独感的关联。在总样本中，分别有19.2%、20.0%和15.3%的人报告有疼痛、疲劳和抑郁。总体上症状群的出现率为4.9%；孤独个体中的患病率显著增加（11.6%对2.3%，P < 0.0001）。在调整人口统计学变量后，孤独感与症状群相关（调整后的OR = 3.39，95%CI = 2.91，3.95）以及与每种症状相关（疼痛调整后的OR = 1.61，95%CI = 1.48，1.76；疲劳调整后的OR = 2.02，95%CI = 1.85，2.20；抑郁调整后的OR = 4.34，95%CI = 3.93，4.79）。孤独感与疼痛、疲劳和抑郁的症状群密切相关。进一步的研究应检查因果关系，并调查针对孤独感的干预措施是否能减轻疼痛、疲劳和抑郁。
