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超越部分之和:痴呆症和慢性疼痛与老年澳大利亚人自我护理限制的综合关联。

Beyond the sum of their parts: The combined association of dementia and chronic pain with self-care limitations in older Australians.

机构信息

School of Business, University of Southern Queensland, Queensland, Toowoomba, Australia.

School of Business, University of Southern Queensland, Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Queensland, Toowoomba, Australia.

出版信息

J Affect Disord. 2025 Jan 15;369:633-642. doi: 10.1016/j.jad.2024.10.046. Epub 2024 Oct 13.

Abstract

BACKGROUND

The purpose of this study was to investigate the association between dementia, chronic pain and self-care limitations. Additionally, the study sought to explore the relationship of co-occurring dementia and chronic pain with self-care limitations.

METHODS

Cross-sectional data derived from the Survey of Disability, Ageing and Carers (SDAC) was used to conduct this study. The pooled association between dementia, and chronic pain, with self-care limitations was assessed using ordered logistic regression model. Furthermore, the study also examined the group comparison of interaction effects between co-occurring dementia and chronic pain with self-care limitations.

RESULTS

The ordered logistic regression analysis indicated that people with dementia had significantly higher odds of experiencing greater self-care limitations (adjusted odds ratio [aOR]: 15.12, 95 % confidence interval [CI]: 12.50-18.29) compared to people without dementia. Similarly, chronic pain was independently associated with increased self-care limitations (aOR: 5.98, 95 % CI: 5.49-6.52) compared to people without chronic pain. Additionally, interaction effect analysis revealed that the co-occurrence of dementia and chronic pain substantially heightened the likelihood of self-care limitations (aOR: 66.54, 95 % CI: 52.27-84.69) relative to people without either condition.

CONCLUSIONS

Disability was higher among older Australians with dementia and chronic pain, and this risk can be increased if the two conditions co-exist. A continuous, aligned, and personalised healthcare approach is needed to establish self-care priorities, especially in groups of people with the greatest need.

摘要

背景

本研究旨在探讨痴呆症、慢性疼痛与自我护理受限之间的关联。此外,本研究还探讨了同时患有痴呆症和慢性疼痛与自我护理受限之间的关系。

方法

本研究使用来自残疾、老龄化和护理者调查(SDAC)的横断面数据。使用有序逻辑回归模型评估痴呆症和慢性疼痛与自我护理受限之间的综合关联。此外,本研究还检查了同时患有痴呆症和慢性疼痛与自我护理受限之间的交互作用的组间比较。

结果

有序逻辑回归分析表明,与无痴呆症的人相比,患有痴呆症的人出现更大自我护理受限的可能性显著更高(调整后的优势比[aOR]:15.12,95%置信区间[CI]:12.50-18.29)。同样,与无慢性疼痛的人相比,慢性疼痛与自我护理受限的增加独立相关(aOR:5.98,95%CI:5.49-6.52)。此外,交互作用效应分析表明,痴呆症和慢性疼痛同时发生显著增加了自我护理受限的可能性(aOR:66.54,95%CI:52.27-84.69),与两种情况都没有的人相比。

结论

痴呆症和慢性疼痛的澳大利亚老年人残疾率更高,如果两种情况同时存在,这种风险会增加。需要采取连续、一致和个性化的医疗保健方法来确定自我护理的优先事项,特别是在最需要的人群中。

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