Prospective associations of chronic and intrusive pain with sarcopenia and physical disability amongst older Australian men: The Concord Health and Ageing in Men Project,Experimental Gerontology

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Prospective associations of chronic and intrusive pain with sarcopenia and physical disability amongst older Australian men: The Concord Health and Ageing in Men Project
Experimental Gerontology ( IF 3.9 ) Pub Date : 2021-07-24 , DOI: 10.1016/j.exger.2021.111501
David Scott ₁ , Fiona Blyth ₂ , Vasi Naganathan ₃ , David G Le Couteur ₄ , David J Handelsman ₅ , Markus J Seibel ₆ , Louise M Waite ₃ , Vasant Hirani ₇

Affiliation

Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.
Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia.
Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia.
Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia.
Bone Research Program, ANZAC Research Institute, Dept of Endocrinology & Metabolism, Concord Hospital, The University of Sydney, New South Wales, Sydney, Australia.
School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.

Background

Associations of chronic and intrusive pain with sarcopenia and disability in older men are unclear.

Methods

1452 community-dwelling men aged ≥70 years self-reported chronic pain (pain every day for ≥3 months) and intrusive pain (pain interfering with normal activities in the last 4 weeks) at baseline and five years later, and were classified as having no, prevalent (baseline only), incident (follow-up only) or persistent (both baseline and follow-up) pain. Appendicular lean mass (ALM), hand grip strength and gait speed were assessed. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Diagnosis and Outcomes Consortium (SDOC) definitions. Activity of daily living (ADL) and instrumental activity of daily living (IADL) impairment were assessed by questionnaires.

Results

Approximately 11% of men reported both chronic and intrusive pain. Gait speed, but not ALM or hand grip strength, significantly mediated the relationship of chronic pain and intrusive pain with ADL and IADL disability by 12–57%. Over five years, incident (odds ratio: 1.84; 95% CI: 1.10–3.10) and persistent (3.02; 1.55–5.88) intrusive pain, and persistent chronic pain (2.29; 1.30–4.04), were associated with increased likelihood of incident sarcopenia (SDOC). Incident and persistent intrusive pain were associated with incident ADL (1.91; 1.04–3.52 and 3.78; 1.90–7.51, respectively) and IADL (2.98; 1.81–4.90 and 4.63; 2.22–9.65, respectively) impairment.

Conclusions

Older men with incident and persistent intrusive pain have increased risk for incident sarcopenia and disability over five years. The association of pain with disability appears to be mediated by gait speed.

中文翻译：

澳大利亚老年男性慢性侵入性疼痛与肌肉减少症和身体残疾的前瞻性关联：Concord 男性健康与老龄化项目

背景

慢性和侵入性疼痛与老年男性肌肉减少症和残疾之间的关联尚不清楚。

方法

1452 名年龄≥70 岁的社区男性在基线和五年后自我报告慢性疼痛（每天疼痛≥3 个月）和侵入性疼痛（疼痛干扰了过去 4 周的正常活动），并被归类为患有否，普遍（仅基线）、偶发（仅随访）或持续（基线和随访）疼痛。评估了阑尾瘦体重（ALM）、握力和步态速度。肌肉减少症是根据欧洲老年人肌肉减少症工作组 (EWGSOP2) 和肌肉减少症诊断和结果联盟 (SDOC) 定义的。通过问卷评估日常生活活动（ADL）和日常生活工具活动（IADL）障碍。

结果

大约 11% 的男性报告了慢性和侵入性疼痛。步态速度，但不是 ALM 或手握力，显着介导慢性疼痛和侵入性疼痛与 ADL 和 IADL 残疾的关系 12-57%。五年多来，事件（比值比：1.84；95% CI：1.10–3.10）和持续性（3.02；1.55–5.88）侵入性疼痛和持续性慢性疼痛（2.29；1.30–4.04）与事件发生的可能性增加有关肌肉减少症（SDOC）。突发性和持续性侵入性疼痛与突发性 ADL（分别为 1.91；1.04–3.52 和 3.78；1.90–7.51）和 IADL（分别为 2.98；1.81–4.90 和 4.63；2.22–9.65）相关。