Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
J Pain. 2023 Jun;24(6):1009-1019. doi: 10.1016/j.jpain.2023.01.014. Epub 2023 Jan 24.
Previous literature has rarely examined the role of pain in the process of disablement. We investigate how pain associates with disability transitions among older adults, using educational attainment as a moderator. Data are from the National Health and Aging Trends Study, N = 6,357; 33,201 1 year transitions between 2010 to 2020. We estimate multinomial logistic models predicting incidence or onset of and recovery from functional limitation and disability. Results show pain significantly predicts functional limitation and disability onset 1 year after a baseline observation, and decreases odds of recovery from functional limitation or disability. Contrary to expectations, higher education does not buffer the association of pain in onset of disability, but supporting expectations, it facilitates recovery from functional limitation or disability among those with pain. The analysis implicates pain as having a key role in the disablement process and suggests that education may moderate this with respect to coping with and subsequently recovering from disability. PERSPECTIVE: This article is among the first examining how pain is placed in the disablement process by affecting onset of and recovery from disability. Both paths are affected by pain, but education moderates the association only with respect to the recovery process.
先前的文献很少探讨疼痛在失能过程中的作用。我们研究了疼痛如何与老年人的残疾转变相关联,使用教育程度作为调节变量。数据来自国家健康老龄化趋势研究,N=6357;2010 年至 2020 年期间有 33201 人在一年内发生功能限制和残疾的转变。我们估计了预测功能限制和残疾起始和恢复的多项逻辑模型。结果表明,疼痛在基线观察后一年显著预测功能限制和残疾的起始,降低了从功能限制或残疾中恢复的可能性。与预期相反,较高的教育程度并不能缓冲疼痛与残疾起始之间的关联,但符合预期的是,它促进了有疼痛的人从功能限制或残疾中恢复。该分析表明疼痛在失能过程中起着关键作用,并表明教育程度可能会在应对残疾和随后从残疾中恢复方面对其进行调节。观点:本文是首批探讨疼痛如何通过影响残疾的起始和恢复而在失能过程中发挥作用的文章之一。这两个路径都受到疼痛的影响,但教育程度仅在恢复过程中调节这种关联。