海南百岁老人慢性疼痛与抑郁的相关性研究

Study on the correlation between chronic pain and depression of centenarians in Hainan

目的调查百岁老人慢性疼痛患病情况,分析该人群中慢性疼痛与抑郁的关联性。方法基于中国海南百岁老人队列研究(CHCCS)2014~2016年横断面调查,选取其中1002例老年人,调查其自述慢性疼痛患病情况,并通过抑郁量表(GDS-15)对百岁老人进行抑郁症状或状态筛查。使用多元logistic回归模型进行抑郁与慢性疼痛的关联性分析。结果共933例老人纳入本研究,老人抑郁患病率30.3%,其中40.6%百岁老人存在1个月以上的慢性疼痛,其主要疼痛部位为腰部(23.0%)和双下肢(44.9%),轻度疼痛(58.6%)、中度疼痛(37.2%)、重度疼痛(4.2%)。单因素分析显示有慢性疼痛老人的抑郁患病率明显高于无慢性疼痛老人,差异有统计学意义(χ2=16.534,P<0.001)。多元logistic回归分析结果显示,腰部、胸部、会阴和下肢部位的疼痛为抑郁患病率的危险因素。以性别为亚组在控制文化程度、婚姻状况、健康自评、最近失禁、自理能力、生活习惯(吸烟、饮酒)、睡眠质量和认知功能等变量后,慢性疼痛老人的发生抑郁的风险是非疼痛组老人的1.38倍(95%CI 1.01~1.87),不同程度慢性疼痛与老人精神抑郁回归分析结果显示,重度疼痛者被诊断为抑郁是无疼痛者的4.04(1.76~13.81)倍。结论该百岁老年人群中的慢性疼痛患病率较高,且与其抑郁症状的发生有关,提示应关注老年群体中因慢性疼痛所带来的精神心理问题。

Objective To investigate the prevalence of chronic pain in centenarians,and analyze the relationship between persistent physical pain and depression.Method The data was from a cross-sectional survey of China's Hainan Centenarian Cohort Study(CHCCS)from 2014 to 2016.Investigate the prevalence of chronic pain in the elderly,and screen the centenarians for depression status through the Depression Scale(GDS-15).Result A total of 933 elderly people were included in the study.The prevalence of depression in the elderly was 30.3%,of which 40.6%of the centenarians had chronic pain for more than one month.The main pain areas were the waist(23.0%)and lower limbs(44.9%),mild pain(58.6%),moderate pain(37.2%)and severe pain(4.2%).Single factor analysis showed that the prevalence of depression in the elderly with chronic pain was significantly higher than that in the elderly without chronic pain(x2=16.534,P<0.001).The results of multiple logistic regression analysis showed that the pain in the waist,chest,perineum and lower limbs was a risk factor for the prevalence of depression.The risk of depression was 1.38 times(95%Cl:1.01-1.87)higher in the chronic pain group than in the non pain group after controlling variables such as education level,marital status,health self-assessment,recent incontinence,self-care ability,living habits(smoking,drinking),sleep quality and cognitive function.The regression analysis of chronic pain and mental depression in the elderly showed that the patients with severe pain were 4.04(1.76-13.81)times more likely to be diagnosed with depression than those without pain Conclusion The prevalence of chronic pain in the centenarian population is high,and it is related to the occurrence of depression symptoms,suggesting that attention should be paid to the mental and psychological problems caused by chronic pain in the elderly.