目的:虚弱是一种多系统综合征,其与症状性骨关节炎的关系已有报道。我们旨在在一个大型前瞻性队列中确定膝关节疼痛的轨迹,并描述基线时虚弱状态对9年以上疼痛轨迹的影响。
方法:我们纳入了4419名参与者(平均年龄61.3岁,58%女性)来自骨关节炎倡议队列。参与者被归类为“无弱点”,\'脆弱前\',或基线处的“脆弱”,基于五个特征(即,无意的减肥,疲惫,弱能量,缓慢的步态速度,和低体力活动)。每年使用西安大略省和麦克马斯特大学骨关节炎指数疼痛子量表(0-20)从基线到9年评估膝关节疼痛。
结果:在包括的参与者中,38.4%,55.4%,6.3%被归类为“无弱点”,\'脆弱前\',和“脆弱”,分别。确定了五个疼痛轨迹:“无痛”(n=1010,22.8%),“轻度疼痛”(n=1656,37.3%),“中度疼痛”(n=1149,26.0%),\'剧烈疼痛\'(n=477,10.9%),和“非常剧烈的疼痛”(n=127,3.0%)。与没有弱点的参与者相比,那些前期虚弱和虚弱的人更有可能有更严重的疼痛轨迹(前期虚弱:赔率比(ORs)1.5至2.1;脆弱:ORs1.5至5.0),在调整了潜在的混杂因素后。进一步的分析表明,虚弱和疼痛之间的关联主要是由疲惫驱动的,缓慢的步态速度,微弱的能量。
结论:大约三分之二的中老年人体弱或体弱。虚弱在预测疼痛轨迹中的作用表明,虚弱可能是膝关节疼痛的重要治疗目标。
OBJECTIVE: Frailty is a multisystem syndrome and its relationship with symptomatic osteoarthritis has been reported. We aimed to identify trajectories of knee pain in a large prospective cohort and to describe the effect of frailty status at baseline on the pain trajectories over 9 years.
METHODS: We included 4419 participants (mean age 61.3 years, 58% female) from the Osteoarthritis Initiative cohort. Participants were classified as \"no frailty,\" \"pre-frailty,\" or \"frailty\" at baseline, based on 5 characteristics (ie, unintentional weight loss, exhaustion, weak energy, slow gait speed, and low physical activity). Knee pain was evaluated annually using the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale (0-20) from baseline to 9 years.
RESULTS: Of the participants included, 38.4%, 55.4%, and 6.3% were classified as \"no frailty,\" \"pre-frailty,\" and \"frailty,\" respectively. Five pain trajectories were identified: \"No pain\" (n = 1010, 22.8%), \"Mild pain\" (n = 1656, 37.3%), \"Moderate pain\" (n = 1149, 26.0%), \"Severe pain\" (n = 477, 10.9%), and \"Very Severe pain\" (n = 127, 3.0%). Compared to participants with no frailty, those with pre-frailty and frailty were more likely to have more severe pain trajectories (pre-frailty: odds ratios [ORs] 1.5 to 2.1; frailty: ORs 1.5 to 5.0), after adjusting for potential confounders. Further analyses indicated that the associations between frailty and pain were mainly driven by exhaustion, slow gait speed, and weak energy.
CONCLUSIONS: Approximately two-thirds of middle-aged and older adults were frail or pre-frail. The role of frailty in predicting pain trajectories suggests that frailty may be an important treatment target for knee pain.