疼痛：影响认知吗？

本文由“小麻哥的日常"授权转载

摘要译文（供参考）

持续性疼痛对老年人功能、认知和幸福感的影响

背景：

我们试图确定持续性疼痛与随后身体功能、认知功能和幸福感变化之间的人口水平的相关性，这对老年人很重要。

方法：

我们使用了2011年至2019年全国健康老龄化趋势研究（NHATS）中65岁以上社区居民医疗保险受益人的数据。

我们将“持续性疼痛”定义为在2011年和2012年的访谈中最后一个月受到疼痛困扰，以及“间歇性”疼痛，包括仅在一次访谈中报告令人困扰的疼痛。

我们使用竞争风险回归来评估持续疼痛与身体功能、认知功能和幸福感的有临床意义下降之间的关联，并在调整基线时年龄、性别、种族、教育程度和婚姻状况。

结果：

在5589名符合条件的NHATS参与者中，38.7%报告持续疼痛，27.8%报告间歇性疼痛。

超过三分之一的人描述了五个或更多部位的疼痛。

在随后的7年中，持续疼痛的参与者更有可能出现身体功能下降（64%持续疼痛，59%间歇性疼痛，57%无困扰疼痛；aHR 1.14，95%CI 1.05-1.23）和幸福感下降（48%持续疼痛，45%间歇性疼痛，44%无困扰痛；aHR 1.11，95%CI 1.01-1.21），但不太可能出现认知功能下降（25%持续性疼痛，24%间歇性疼痛，23%无痛苦；aHR 1.02，95%CI 0.90-1.16）。

结论：

持续性疼痛在老年人中很常见，并发生在多个身体部位。

持续疼痛会导致身体机能和幸福感在7年内显著下降，因此需要采取积极的干预措施来减轻疼痛。

关键词：

老化；慢性疼痛；持续疼痛；身体功能；幸福感

Impact of persistent pain on function, cognition, and well-being of older adults

Background:We sought to determine the population-level associations between persistent pain and subsequent changes in physical function, cognitive function, and well-being, outcomes important to older adults.

Methods:We used data from National Health Aging Trends Study (NHATS) of community-dwelling Medicare beneficiaries age 65+ from 2011 to 2019. We defined "persistent pain" as being bothered by pain in the last month in both the 2011and 2012 interviews and "intermittent" pain including those reporting bothersome pain in one interview only. We used competing risks regression to estimate the association between persistent pain and the development of clinically meaningful declines in physical function, cognitive function, and well-being, adjusting for age, sex, race, education, and marital status at baseline.

Results:Of the 5589 eligible NHATS participants, 38.7% reported persistent pain and 27.8% reported intermittent pain. Over one-third described pain in five or more sites. Over the subsequent 7 years, participants with persistent pain were more likely to experience declines in physical function (64% persistent pain, 59% intermittent pain, 57% no bothersome pain; aHR 1.14, 95% CI 1.05-1.23) and well-being (48% persistent pain, 45% intermittent pain, 44% no bothersome pain; aHR 1.11, 95% CI 1.01-1.21), but were not more likely to experience cognitive decline (25% persistent pain, 24% intermittent pain, 23% no bothersome pain; aHR 1.02, 95% CI 0.90-1.16).

Conclusions:Persistent pain is common in older adults and occurs in multiple body sites. Persistent pain contributes to meaningful declines in physical function and well-being over 7 years and warrants proactive interventions to mitigate pain.

Keywords:aging; chronic pain; persistent pain; physical function; well-being.

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编辑：Michel.米萱

校对：Mijohn.米江