Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Gastroenterology, Jiangyou 903 Hospital, Mianyang, Sichuan, China.
J Am Geriatr Soc. 2023 Feb;71(2):546-552. doi: 10.1111/jgs.18118. Epub 2022 Nov 4.
Pain-related muscle disuse and inflammatory reactions may increase the risk of sarcopenia among older adults with pain. Although several studies have examined the association between pain and sarcopenia, the findings are mixed. In the present study, we examined the association of pain as well as pain intensity and location with incident sarcopenia among community-dwelling older adults and explored whether this association differed between men and women.
Pain characteristics, including the presence of pain, intensity (mild, moderate, and severe), and location (multisite, low back, joint, and chest), were self-reported at baseline. Sarcopenia was identified according to the consensus of the Asin Working Group for Sarcopenia 2019 at baseline and 1 year later. Multivariable Poisson regression was used to determine the association of pain status, intensity, and location with incident sarcopenia, respectively.
Eight hundred seventy-three participants (67.1 ± 4.9 years, 524 female) who were free of sarcopenia at baseline were included, of which 64 (7.3%) developed sarcopenia in the follow-up. The presence of pain was significantly associated with an increased risk of incident sarcopenia in older adults (adjusted RR = 1.83, 95% CI = 1.16-2.89), with a significant risk accumulation in incident sarcopenia upon higher pain intensity. Older adults with multisite pain, low back pain, or joint pain were more likely to develop sarcopenia. Although older men reported a lower prevalence and intensity of pain, their risk of sarcopenia during follow-up was generally more pronounced than older women.
Older adults with pain had a significantly higher risk of incident sarcopenia, with a significant risk accumulation in sarcopenia development upon higher pain intensity and specific pain location. Additional attention is needed to identify older adults with pain and to implement timely pain interventions to prevent sarcopenia. High-quality randomized controlled trials are warranted to verify the clinical significance of the present study.
疼痛相关的肌肉废用和炎症反应可能会增加老年人疼痛相关的肌肉减少症风险。尽管有几项研究探讨了疼痛与肌肉减少症之间的关系,但结果存在差异。本研究旨在调查社区居住的老年人中疼痛以及疼痛强度和部位与新发肌肉减少症之间的关系,并探讨这种关系在男性和女性之间是否存在差异。
在基线时,通过自我报告的方式获取疼痛特征,包括疼痛的存在、强度(轻度、中度和重度)和部位(多部位、下背部、关节和胸部)。根据 2019 年亚洲肌肉减少症工作组的共识,在基线和 1 年后分别确定肌肉减少症的发生。使用多变量泊松回归来确定疼痛状况、强度和部位与新发肌肉减少症的关系。
共纳入了 873 名基线时无肌肉减少症的参与者(67.1±4.9 岁,524 名女性),其中 64 名(7.3%)在随访中出现了肌肉减少症。疼痛的存在与老年人新发肌肉减少症的风险增加显著相关(调整后的 RR=1.83,95%CI=1.16-2.89),且随着疼痛强度的增加,新发肌肉减少症的风险也随之增加。多部位疼痛、下背痛或关节痛的老年人更有可能发生肌肉减少症。尽管老年男性报告的疼痛发生率和强度较低,但他们在随访期间发生肌肉减少症的风险通常比老年女性更为显著。
有疼痛的老年人发生新发肌肉减少症的风险显著增加,且随着疼痛强度的增加和特定疼痛部位的出现,肌肉减少症的发展风险也显著增加。需要额外关注有疼痛的老年人,并实施及时的疼痛干预措施来预防肌肉减少症。需要进行高质量的随机对照试验来验证本研究的临床意义。