Miki Takahiro, Cooray Upul, Kanai Masashi, Hagiwara Yuta, Ikeda Takaaki
Insight Lab, PREVENT Inc., Aichi, Japan.
Graduate School of Rehabilitation Science, Saitama Prefectural University, Japan.
EClinicalMedicine. 2024 Feb 8;69:102477. doi: 10.1016/j.eclinm.2024.102477. eCollection 2024 Mar.
It remains uncertain whether cultural engagement positively influences the reduction of pain risk, particularly depending on the social isolation status. The aim of this study was to examine the impact of cultural engagement on the reduction of pain prevalence over a 6-year follow-up period among older people, particularly those experiencing different dimensions of social isolation.
This study was a prospective longitudinal study. We analysed the English Longitudinal Study of Ageing cohort, consisting of 6468 community-dwelling adults aged ≥50 years old who provided data in waves 6 (2012-2013), 7 (2014-2015), 8 (2016-2017), and 9 (2018-2019). Self-reported cultural engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera) measured in waves 6-8 was used as the exposure variable. Meanwhile self-reported moderate-to-severe pain in wave 9 was used as the outcome variable. Social isolation was considered in waves 6-8, and the possibility of effect modification was captured by assessing each component of the social isolation index: not married or cohabiting with a partner, fewer than monthly contact with children/other immediate family/friends, and not engaging in any organisations, religious groups, or committees.
The estimated pain prevalence was 29.2% (95% confidence interval, 28.1-30.3; reference) after adjusting for time-variant, time-invariant, and loss to follow-up factors. Cultural engagement led to a reduction in pain prevalence to 24.1% for all individuals, representing a decrease of 5.1% (95% confidence interval, 0.6-9.6; -value, 0.03). In older people who were not married or cohabiting, cultural engagement resulted in a decrease in pain prevalence to 25.8%, a reduction of 3.4% (95% confidence interval, 0.4-6.4; -value, 0.01). For those with less frequent contact with close family members, the pain prevalence decreased to 25.3%, a reduction of 3.9% (95% confidence interval, 0.2-7.6; -value, 0.03). Meanwhile, other dimensions of social isolation did not show a significant reduction in pain prevalence.
Cultural engagement may help to reduce the risk of pain in socially isolated older adults. Those who were single or living alone and had less frequent contact with immediate family were particularly vulnerable. While cultural engagement might help certain socially isolated older people feel better, its effectiveness varies, highlighting the need for targeted interventions.
The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number (22K17648, Ikeda).
文化参与是否对降低疼痛风险有积极影响仍不确定，尤其是取决于社会隔离状态。本研究的目的是在6年随访期内，研究文化参与对老年人疼痛患病率降低的影响，特别是对经历不同维度社会隔离的老年人。
本研究是一项前瞻性纵向研究。我们分析了英国老龄化纵向研究队列，该队列由6468名年龄≥50岁的社区居住成年人组成，他们在第6波（2012 - 2013年）、第7波（2014 - 2015年）、第8波（2016 - 2017年）和第9波（2018 - 2019年）提供了数据。在第6 - 8波中测量的自我报告的文化参与（去博物馆、艺术画廊、展览、剧院、音乐会或歌剧院）被用作暴露变量。同时，第9波中自我报告的中度至重度疼痛被用作结果变量。在第6 - 8波中考虑了社会隔离，并通过评估社会隔离指数的每个组成部分来捕捉效应修正的可能性：未婚或未与伴侣同居、与子女/其他直系亲属/朋友每月联系少于一次、不参与任何组织、宗教团体或委员会。
在调整了随时间变化、不随时间变化和失访因素后，估计的疼痛患病率为29.2%（95%置信区间，28.1 - 30.3；参考值）。文化参与使所有个体的疼痛患病率降至24.1%，下降了5.1%（95%置信区间，0.6 - 9.6；P值，0.03）。在未婚或未同居的老年人中，文化参与使疼痛患病率降至25.8%，下降了3.4%（95%置信区间，0.4 - 6.4；P值，0.01）。对于与亲密家庭成员联系较少的人，疼痛患病率降至25.3%，下降了3.9%（95%置信区间，0.2 - 7.6；P值，0.03）。同时，社会隔离的其他维度在疼痛患病率上未显示出显著降低。
文化参与可能有助于降低社会隔离的老年人的疼痛风险。单身或独居且与直系亲属联系较少的人尤其脆弱。虽然文化参与可能有助于某些社会隔离的老年人感觉更好，但其效果各不相同，这凸显了针对性干预的必要性。
日本学术振兴会（JSPS）科研资助金编号（22K17648，池田）。
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