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智利人群中的慢性疼痛:危险因素、患病率及认知关联

Chronic pain in the Chilean population: risk factors prevalence and cognitive associations.

作者信息

Hernández Hernán, Ochoa-Rosales Carolina, Ibáñez Agustín, Oyanadel Lorena, Olavarria Loreto, Marín-Díaz Nickole, Caviedes Ariel, Hazelton Jessica L, Ramos Teresita, Santamaria-García Hernando, Custodio Nilton, Montesinos Rosa, Bruno Martin A, Avila-Funes Jose A, Matallana Diana, de la Cruz Rolando, Petermann-Rocha Fanny, Slachevsky Andrea, Duran-Aniotz Claudia, Gonzalez-Silva Carolina

机构信息

Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.

Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.

出版信息

Front Aging. 2025 Jul 22;6:1548667. doi: 10.3389/fragi.2025.1548667. eCollection 2025.

Abstract

Chronic pain (CP) is a global public health issue and a critical factor in the aging process. Chile, as one of the most aged countries in Latin America, presents a unique context for exploring CP and its associated factors. Despite its significance in aging, previous studies in the region often fail to comprehensively address key variables such as age, income, mood, mobility, diet, and cognitive skills, nor do they systematically investigate the relationship between CP and cognitive impairment. This study presents a comprehensive analysis of CP prevalence, related sociodemographic and health variables, and its link to cognitive impairment, using representative data of the Chilean population 15 years and older from the 2009-2010 and 2016-2017 Chilean National Health Surveys (CNHS). In the expanded sample of 12,791,542 and 13,399,937 individuals respectively, the overall prevalence of CP was 46.0% in the 2009-2010 CNHS and 28.9% in the 2016-2017 CNHS, with prevalence increasing with age. CP ranged from 26.6% among individuals aged 15-24 years to 59.9% among those aged 65-80 years in the 2009-2010 CNHS, and from 16.6% to 40.2% in the 2016-2017 CNHS. Female participants consistently reported higher CP rates, with significantly higher prevalence than males across age groups 15-64 years. Using complex survey logistic regression analyses, we identified several factors that were significantly associated with CP, including reduced mobility, depression, anxiety, socioeconomic disadvantage, and lower educational attainment. Machine learning techniques were employed to classify CP and non-CP cases, providing a nuanced understanding of the complex interplay between factors that influence CP. In a secondary analysis among those 60 years and older, no significant difference in CP prevalence was observed between individuals with and without cognitive impairment measured with an abbreviated MiniMental State Examination test. However, those with cognitive impairment tended to report pain in a greater number of anatomical sites. This study provides the first nationally representative evidence of CP in Chile in relation to age, income, mood, mobility, diet, and cognitive performance. These findings contribute to the understanding of CP as a public health issue in Latin America. The study underscores the need for targeted interventions to promote healthy longevity and reduce the burden of chronic diseases in aging populations.

摘要

慢性疼痛(CP)是一个全球性的公共卫生问题,也是衰老过程中的一个关键因素。智利作为拉丁美洲老龄化程度最高的国家之一,为探索慢性疼痛及其相关因素提供了独特的背景。尽管其在老龄化过程中具有重要意义,但该地区以往的研究往往未能全面涉及年龄、收入、情绪、活动能力、饮食和认知技能等关键变量,也没有系统地研究慢性疼痛与认知障碍之间的关系。本研究利用2009 - 2010年和2016 - 2017年智利全国健康调查(CNHS)中15岁及以上智利人口的代表性数据,对慢性疼痛的患病率、相关的社会人口统计学和健康变量及其与认知障碍的联系进行了全面分析。在分别扩大到12,791,542人和13,399,937人的样本中,2009 - 2010年CNHS中慢性疼痛的总体患病率为46.0%,2016 - 2017年CNHS中为28.9%,患病率随年龄增长而增加。在2009 - 2010年CNHS中,15 - 24岁人群的慢性疼痛患病率为26.6%,65 - 80岁人群中为59.9%;在2016 - 2017年CNHS中,患病率则从16.6%至40.2%不等。女性参与者报告的慢性疼痛发生率一直较高,在15 - 64岁的各年龄组中,患病率均显著高于男性。通过复杂的调查逻辑回归分析,我们确定了几个与慢性疼痛显著相关的因素,包括活动能力下降、抑郁、焦虑、社会经济劣势和教育程度较低。我们采用机器学习技术对慢性疼痛和非慢性疼痛病例进行分类,从而对影响慢性疼痛的因素之间的复杂相互作用有了更细致入微的理解。在对60岁及以上人群的二次分析中,使用简易精神状态检查表测量,有认知障碍和无认知障碍的个体之间慢性疼痛患病率没有显著差异。然而,有认知障碍的人往往报告疼痛的解剖部位更多。本研究提供了智利首个关于慢性疼痛与年龄、收入、情绪、活动能力、饮食和认知表现的全国代表性证据。这些发现有助于将慢性疼痛理解为拉丁美洲的一个公共卫生问题。该研究强调了有针对性干预措施的必要性,以促进健康长寿并减轻老年人群中慢性病的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/435d/12321896/b494eaa947aa/fragi-06-1548667-g001.jpg

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