Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
J Am Med Dir Assoc. 2024 Sep;25(9):105153. doi: 10.1016/j.jamda.2024.105153. Epub 2024 Jul 14.
The association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association.
We used a quantitative cross-sectional study design.
Representative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used.
PA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations.
The analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%).
Moving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.
已经描述了体力活动（PA）与疼痛之间的关联。尽管文献主要来自高收入国家，但这种关联的潜在机制仍不清楚，特别是在中低收入国家（LMICs）。我们旨在研究符合世界卫生组织（WHO）PA 指南与老年人疼痛之间的关联，并确定可能介导这种关联的因素。
我们使用了定量的横断面研究设计。
使用参加老龄化、健康、心理幸福感和健康寻求行为研究的年龄≥50 岁的成年人的代表性数据。
使用国际体力活动问卷（IPAQ）定义 PA。使用经过跨文化验证的项目在过去一个月内自我报告疼痛经历来评估疼痛严重程度。调整后的多变量有序逻辑回归和中介模型量化了假设的关联。
分析包括 1201 名成年人（平均年龄 66.1 ± 11.9 岁；63.3%为女性）。在调整混杂因素后，遵循 WHO 推荐的 PA 指南与严重/极度疼痛的可能性降低 42%相关[比值比（OR）0.58，95%置信区间（CI）0.44-0.77]。在男性（OR 0.52，95%CI 0.31-0.85）中，这种关联比女性（OR 0.60，95%CI 0.42-0.87）更强。PA-疼痛关联由功能限制（84.7%）、自我评估健康（76.6%）、睡眠问题（20.4%）和损伤（6.6%）解释。
在来自 LMICs 的老年人中，更多的运动与更少的疼痛相关。在老年人群中，疼痛管理干预措施可能需要侧重于提高对 PA 剂量的依从性，特别是在 LMICs。然而，需要进行纵向数据来确认这些发现。
