Witonsky Kailyn, Zhu Xiaonan, Rosso Andrea L, Newman Anne, Rosano Caterina
Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA.
Model Development BNY Mellon Center Pittsburgh Pennsylvania USA.
Health Sci Rep. 2025 Feb 12;8(2):e70367. doi: 10.1002/hsr2.70367. eCollection 2025 Feb.
Joint pain is common and limits leisure-time physical activity (LTPA) in older adults. However, some older adults with pain are also physically active. Psychosocial factors that may indicate external engagement (such as social network) and internal drive (such as feeling able to "get going") are emerging as predictors of LTPA and may explain why some older adults with pain are physically active.
We investigated the cross-sectional association of psychosocial factors with LTPA (kcal/week) in adults over the age of 64 with pain in their back, hips, knees and/or feet from the Cardiovascular Health Study. Psychosocial factors included: social network score from the Lubben Social Network scale and three questions from the Center of Epidemiologic Studies Depression Scale (CES-D): perceived effort, difficulty getting going, and trouble concentrating. Separate multivariable ordinal regression models estimated the association between these indicators and LTPA, while controlling for demographics and other contributors of LTPA: number of medications, number of pain sites, body mass index, gait speed, digit substitution symbol test, brain white matter hyperintensities, and mood.
Among 902 participants (65% female, 14% Non-White) with joint pain and complete data, higher social network score, and no self-reported "difficulty getting going" were associated with higher levels of LTPA, independent of covariates. Associations with perceived effort or trouble concentrating were not statistically significant.
Our research suggests that some older adults with pain are physically active and psychosocial factors related to external engagement and internal drive might be important targets to support LTPA. Studies should investigate the role of psychosocial states on LTPA among older adults with pain.
We certify that this work is novel.The potential impact of this research on clinical care includes the following: Resiliency factors such as psychosocial factors may be more important targets to promote leisure-time physical activity in older adults with pain than specific pain reduction strategies.
关节疼痛很常见，会限制老年人的休闲体育活动（LTPA）。然而，一些疼痛的老年人也积极参加体育活动。可能表明外部参与（如社交网络）和内在动力（如感觉能够“行动起来”）的社会心理因素正逐渐成为LTPA的预测因素，这或许可以解释为什么一些疼痛的老年人仍积极参加体育活动。
我们在心血管健康研究中，调查了64岁以上背部、臀部、膝盖和/或足部疼痛的成年人中，社会心理因素与LTPA（千卡/周）之间的横断面关联。社会心理因素包括：来自鲁本社交网络量表的社交网络得分，以及来自流行病学研究中心抑郁量表（CES-D）的三个问题：感知努力程度、行动困难程度和注意力不集中问题。单独的多变量有序回归模型估计了这些指标与LTPA之间的关联，同时控制了人口统计学因素和LTPA的其他影响因素：用药数量、疼痛部位数量、体重指数、步速、数字替代符号测试、脑白质高信号和情绪。
在902名有关节疼痛且数据完整的参与者（65%为女性，14%为非白人）中，较高的社交网络得分以及没有自我报告的“行动困难”与较高水平的LTPA相关，且不受协变量影响。与感知努力程度或注意力不集中问题的关联无统计学意义。
我们的研究表明，一些疼痛的老年人积极参加体育活动，与外部参与和内在动力相关的社会心理因素可能是支持LTPA的重要目标。研究应调查社会心理状态在疼痛老年人LTPA中的作用。
我们证明这项工作具有创新性。这项研究对临床护理的潜在影响包括：社会心理因素等复原力因素，可能比特定的疼痛减轻策略，更重要的促进疼痛老年人休闲体育活动的目标。
