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接受阿片类药物使用障碍药物治疗的老年人和年轻人的身心健康特征。

Mental and physical health characteristics of older and younger adults receiving medication for opioid use disorder.

作者信息

Walker Teresa J, Mohankumar Rakshitha, Kraus Shane W, Cotton Brandi P, Renn Brenna N

机构信息

Department of Psychology, University of Nevada, Las Vegas, NV, United States.

Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.

出版信息

Front Public Health. 2024 Nov 12;12:1418690. doi: 10.3389/fpubh.2024.1418690. eCollection 2024.

Abstract

BACKGROUND

Methadone is an effective and widely used medication for opioid use disorder (MOUD). Within in the United States (US), older adults represent an increasing proportion of those receiving MOUD, yet little is known about characteristics of older individuals in these programs.

OBJECTIVES

To evaluate mental and physical health characteristics of younger and older adults receiving MOUD and test whether age moderates the relation between physical and mental health variables.

METHODS

Data for this secondary analysis are drawn from a cross-sectional survey of a convenience sample of individuals seeking methadone dosing as part of MOUD at four opioid treatment programs in two regions of the US. Descriptive statistics and correlational and moderation analyses examined outcomes of pain severity, pain interference, self-rated health, physical activity, depression, and anxiety across younger (18-49) and older (50+ years) participants.

RESULTS

Analyses included 469 participants (mean [range] age, 41.01 [20-70] years). Older participants reported higher pain severity and interference, less physical activity, and worse self-rated health than those in the younger age group (s < 0.05). Associations between mental and physical health variables were generally weak-to-moderate in the older age group ( = 0.26 to  = 0.44,  < 0.01), and weak in the younger age group, although age did not moderate associations.

CONCLUSION

Clinically significant mental and physical health variables are associated among individuals receiving methadone for MOUD, with older adults facing unique challenges.

CLINICAL IMPLICATIONS

Opioid use treatment should include not only pain management but also assessment and treatment of depression and anxiety and optimization of other health behaviors (e.g., physical activity) across age groups. Pain management and health promotion are particularly relevant targets for aging individuals receiving MOUD.

摘要

背景

美沙酮是一种用于阿片类物质使用障碍(MOUD)的有效且广泛使用的药物。在美国,接受MOUD治疗的老年人比例日益增加,但对于这些项目中老年人的特征了解甚少。

目的

评估接受MOUD治疗的年轻人和老年人的身心健康特征,并检验年龄是否调节身心健康变量之间的关系。

方法

本次二次分析的数据来自对美国两个地区四个阿片类物质治疗项目中寻求美沙酮剂量作为MOUD一部分的便利样本进行的横断面调查。描述性统计以及相关性和调节分析考察了年龄较小(18 - 49岁)和年龄较大(50岁及以上)参与者在疼痛严重程度、疼痛干扰、自评健康状况、身体活动、抑郁和焦虑方面的结果。

结果

分析纳入了469名参与者(平均[范围]年龄为41.01[20 - 70]岁)。与年龄较小的组相比,年龄较大的参与者报告的疼痛严重程度和干扰更高,身体活动更少,自评健康状况更差(s < 0.05)。在年龄较大的组中,身心健康变量之间的关联通常为弱到中等(= 0.26至 = 0.44,< 0.01),而在年龄较小的组中则较弱,尽管年龄并未调节这些关联。

结论

接受美沙酮治疗MOUD的个体中,具有临床意义的身心健康变量之间存在关联,老年人面临独特的挑战。

临床意义

阿片类物质使用治疗不仅应包括疼痛管理,还应包括对抑郁和焦虑的评估与治疗,以及各年龄组其他健康行为(如身体活动)的优化。疼痛管理和健康促进对于接受MOUD治疗的老年人尤其重要。

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