背景:随着研究调查,资源,童年的限制会影响以后的健康和福祉。本研究通过研究印度老年人中几种早期生活因素与自我报告的疼痛之间的关联,为该文献做出了贡献。
方法:数据来自印度纵向老龄化研究(LASI)的2017-18波1。样本量包括28,050名60岁及以上的老年人(13,509名男性和14,541名女性)。疼痛是一种自我报告,参与者对他们是否经常受到疼痛困扰以及这种经历是否干扰了他们进行日常家务的能力做出反应。早期生活因素,这些是对经历的回顾性描述,包括被调查者在出生顺序中的位置,他们的健康状况,学校旷工,卧床不起,家庭社会经济地位(SES),和他们的父母与慢性疾病的经验。采用Logistic回归分析来检查与经历疼痛的概率相关的早期生活因素的选定领域的未调整和调整的平均边际效应(AME)。
结果:22.8%的男性和32.3%的女性报告疼痛会干扰日常活动。与第一次出生顺序相比,第三次或第四次出生顺序的男性(AME:0.01,置信区间(CI):0.01-0.03)和女性(AME:0.02,CI:0.01-0.04)的疼痛更高。具有良好儿童健康状况的男性(AME:-0.02,CI:-0.04-0.01)和女性(AME:-0.07,CI:-0.09--0.04)均报告了较低的疼痛概率。在童年时期因疾病卧床不起的男性(AME:0.03,CI:0.01-0.07)和女性(AME:0.07,CI:0.03-0.13)中,疼痛的可能性更高。同样,在因健康问题缺课超过1个月的男性中,疼痛可能性较高(AME:0.04,CI:-0.01~0.09).童年时期经济状况不佳的男性和女性报告(AME:0.04,CI:0.01-0.07)相对于报告经济状况较好的早期生活的同龄人,经历疼痛的可能性更高。
结论:本研究的结果增加了关于早期生活因素与以后生活健康和幸福之间关联的实证文献。它们还与从事疼痛管理的医疗保健提供者和从业人员有关,因为这些知识更好地定位他们以识别最容易疼痛的老年人。此外,我们的研究结果强调,确保晚年健康和福祉的干预措施必须在生命过程中更早开始。
The influence of early life factors is becoming increasingly apparent as studies investigate how experiences, resources, and constraints in childhood affect health and well-being later in life. The present study contributes to this literature by examining the association between several early life factors and self-reported pain among older adults in India.
Data come from the 2017-18 wave 1 of the Longitudinal Ageing Study of India (LASI). The sample size includes 28,050 older adults aged 60 and above (13,509 men and 14,541 women). Pain is a self-reported, dichotomous measure where participants responded to whether they were often troubled with pain and whether this experience interfered with their ability to carry out daily household chores. Early life factors, which are retrospective accounts of experiences, included the respondent\'s position in birth order, their health status, school absenteeism, being bedridden, family socioeconomic status (SES), and their parent\'s experience with chronic disease. Logistic regression analysis is employed to examine the unadjusted and adjusted average marginal effects (AME) of selected domains of early life factors associated with the probability of experiencing pain.
22.8% of men and 32.3% of women reported pain that interfered with daily activities. Pain was higher among men (AME: 0.01, confidence interval (CI): 0.01-0.03) and women (AME: 0.02, CI: 0.01-0.04) with third or fourth birth order compared to counterparts with first birth order. Both men (AME: -0.02, CI: -0.04-0.01) and women (AME: -0.07, CI: -0.09 - -0.04) having a fair childhood health status reported a lower probability of pain. The probability of pain was higher among both men (AME: 0.03, CI: 0.01-0.07) and women (AME: 0.07, CI: 0.03-0.13) who were bedridden due to sickness in their childhood. Similarly, the pain likelihood was higher among men who missed school for more than a month due to health problems (AME: 0.04, CI: -0.01-0.09). Men and women with poor financial condition in their childhood reported (AME: 0.04, CI: 0.01-0.07) a higher probability of experiencing pain relative to their peers who reported a more financially advantaged early life.
Findings of the present study add to the empirical literature on the association between early life factors and later life health and well-being. They also are pertinent to health care providers and practitioners working in pain management, as this knowledge better positions them to identify older adults most susceptible to pain. Moreover, findings of our study underscore that the interventions to ensure health and well-being in later life must start far earlier in the life course.