National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Aging Clin Exp Res. 2022 Oct;34(10):2515-2523. doi: 10.1007/s40520-022-02192-y. Epub 2022 Aug 25.
Falls are major health care concerns for older adults. Pain is associated with increased falls in older adults. However, the impact of pain on functional disability and how this might predispose Chinese older adults to fall is unclear.
The aim of the current study was to examine whether functional disability mediates the association of any pain, back and/or shoulder pain (B-S pain) and leg and/or knees pain (L-K pain) with falls and serious falls.
The study included 7619 community-dwelling older adults aged 60 years and above from the China Health and Retirement Longitudinal Study. Baseline data were from Wave 3 and fall outcomes were from Wave 4. Functional disability was measured by the ADLs and IADLs scales. We used a logistic regression model to investigate associations between pain and fall outcomes and KHB method to estimate the mediating effects of ADL/IADL disability on pain-fall relationship.
After fully adjusting for covariates, the three pain measures (any pain, back and/or shoulder pain, leg and/or knees pain) were significantly associated with fall outcomes. When body pain was compared with no body pain, the proportion mediated by the ADL disability was 28.43% for falls, while the proportion mediated by IADL disability was 17.96% for falls. For associations between specific parts of body pain and falls, the proportions mediated by the ADL disability were 34.18% and 35.89% in back and/or shoulder pain and leg and/or knees pain, respectively, but the proportions reduced to 21.98% and 20.82% when mediated by the IADL disability. However, there were no significant contributions of ADL/IADL disability for the association between specific part of body pain and serious falls.
Pain in general and pain in specific body sites were significantly associated with an increased risk of fall among older adults living in community in China. Functional disability partially mediated the relationship of pain with falls.
跌倒对老年人来说是一个严重的医疗保健问题。疼痛与老年人跌倒增加有关。然而，疼痛对功能障碍的影响以及这如何使中国老年人更容易跌倒尚不清楚。
本研究旨在探讨功能障碍是否可以调节任何疼痛、背部和/或肩部疼痛（B-S 疼痛）以及腿部和/或膝盖疼痛（L-K 疼痛）与跌倒和严重跌倒的关系。
本研究纳入了来自中国健康与退休纵向研究的 7619 名 60 岁及以上的社区居住老年人。基线数据来自第 3 波，跌倒结局来自第 4 波。功能障碍通过 ADL 和 IADL 量表进行测量。我们使用逻辑回归模型来研究疼痛与跌倒结局之间的关联，并使用 KHB 方法来估计 ADL/IADL 残疾对疼痛-跌倒关系的中介作用。
在充分调整了协变量后，三种疼痛测量方法（任何疼痛、背部和/或肩部疼痛、腿部和/或膝盖疼痛）与跌倒结局显著相关。与无身体疼痛相比，当身体疼痛与身体疼痛相比时，ADL 残疾介导的比例为 28.43%，而 IADL 残疾介导的比例为 17.96%。对于特定身体部位疼痛与跌倒之间的关联，ADL 残疾介导的比例分别为背部和/或肩部疼痛和腿部和/或膝盖疼痛的 34.18%和 35.89%，但当 IADL 残疾介导时，比例降至 21.98%和 20.82%。然而，ADL/IADL 残疾对特定身体部位疼痛与严重跌倒之间的关联没有显著贡献。
一般疼痛和特定身体部位的疼痛与中国社区老年人跌倒风险增加显著相关。功能障碍部分介导了疼痛与跌倒之间的关系。
