Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology.
Japan Society for the Promotion of Science.
J Epidemiol. 2024 Jun 5;34(6):270-277. doi: 10.2188/jea.JE20230127. Epub 2024 Mar 31.
BACKGROUND: Per the biopsychosocial model, pain, especially chronic low back pain, which often presents with nonspecific pain, requires a comprehensive approach involving social factors. However, the association of social factors, including social isolation and loneliness, with this condition remains unclear. This study examined the cross-sectional association of social isolation and loneliness with chronic low back pain among older adults. METHODS: We recruited functionally independent older adults through a mail survey in 2019 from the Japan Gerontological Evaluation Study (JAGES). Chronic low back pain was defined as low back pain lasting more than 3 months. Social isolation was identified based on face-to-face and non-face-to-face interactions ("not isolated," "isolated tendency," and "isolated"). Loneliness was assessed using the University of California, Los Angeles Loneliness Scale ("not lonely," "lonely tendency," and "lonely"). RESULTS: Consequently, 21,463 participants were analyzed (mean age: 74.4 years; 51.5% females); 12.6% reported chronic low back pain. Multivariable Poisson regression analysis revealed that loneliness was significantly associated with the likelihood of chronic low back pain; compared with "not lonely", the prevalence ratio (PR) was 1.14 (95% confidence interval [CI], 1.05-1.25) for "lonely tendency" and 1.40 (95% CI, 1.27-1.54) for "lonely." Social isolation was not associated; compared with "not isolated," the PR was 0.96 (95% CI, 0.88-1.05) for "isolated tendency" and 0.99 (95% CI, 0.89-1.10) for "isolated." A positive multiplicative interaction between social isolation and loneliness for chronic low back pain was found. CONCLUSION: Lonelier individuals were more likely to experience chronic low back pain, and those with loneliness and social isolation were synergistically more likely for this condition.
背景:根据生物心理社会模式,疼痛,尤其是常表现为非特异性疼痛的慢性下背痛,需要采用包括社会因素在内的综合方法进行治疗。然而,社会因素(包括社会隔离和孤独)与这种情况之间的关联尚不清楚。本研究旨在探讨社会隔离和孤独感与老年人慢性下背痛之间的横断面关联。
方法:我们于 2019 年通过邮件调查从日本老年评估研究(JAGES)中招募了功能独立的老年人。慢性下背痛的定义为持续 3 个月以上的下背痛。社会隔离是基于面对面和非面对面的互动来确定的(“不孤立”、“孤立倾向”和“孤立”)。孤独感使用加利福尼亚大学洛杉矶分校孤独量表(“不孤独”、“孤独倾向”和“孤独”)进行评估。
结果:共有 21463 名参与者进行了分析(平均年龄:74.4 岁;51.5%为女性);12.6%报告有慢性下背痛。多变量泊松回归分析显示,孤独感与慢性下背痛的发生显著相关;与“不孤独”相比,“孤独倾向”的患病率比(PR)为 1.14(95%可信区间 [CI],1.05-1.25),“孤独”为 1.40(95%CI,1.27-1.54)。社会隔离与慢性下背痛无关;与“不孤立”相比,“孤立倾向”的 PR 为 0.96(95%CI,0.88-1.05),“孤立”的 PR 为 0.99(95%CI,0.89-1.10)。还发现社会隔离和孤独感对慢性下背痛存在正相乘交互作用。
结论:更孤独的个体更有可能经历慢性下背痛,而那些同时存在孤独感和社会隔离的个体更有可能出现这种情况。
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