Patterns of Pain in Middle-Aged and Older Adults in China: A Latent Class Analysis.

IF 3.3 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2025-10-08 DOI:10.1007/s40122-025-00775-x

Changsen Zhu, Yiyi Xu, Zhenping Lin, Weibang Xu, Zhuoming Chen

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Abstract

Introduction: Chronic pain is a leading global cause of disability in aging populations, yet pain distribution patterns among middle-aged and older adults in China remain uncharacterized. Using latent class analysis (LCA), this study identified distinct pain location patterns and their associations with cognitive impairment, depressive symptoms, and functional limitations.

Methods: A cross-sectional analysis of 9544 participants from the CHARLS 2020 database was conducted. LCA categorized pain patterns, and multivariate logistic regression examined influencing factors and associations with cognitive impairment, depressive symptoms, and activities of daily living (ADL) impairment. Model fit was optimized via AIC/BIC and entropy/posterior probabilities (> 0.8).

Results: Four distinct categories were identified: the broad pain group (n = 935, 9.8%), the shoulder-low back pain group (n = 2426, 25.4%), the lower limb pain group (n = 2568, 26.9%), and the head-neck-stomach pain group (n = 3615, 37.9%). The analysis revealed significant associations between pain location patterns and variables such as sex, income, and the presence of multiple comorbidities, including dyslipidemia, stomach disease, cancer, asthma, chronic lung disease, stroke, kidney disease, arthritis, mood disorders, Parkinson's disease, and memory-related diseases. In addition, the broad pain group showed stronger associations with cognitive impairment, depressive symptoms, and ADL difficulties (including BADL difficulties and IADL difficulties), and the lower limb pain group was associated with a significantly higher likelihood of ADL impairment than the head-neck-stomach pain group.

Conclusions: Pain patterns in Chinese adults ≥ 45 years reflect distinct phenotypes with differential health risks. The broad pain group warrants comprehensive intervention targeting pain, cognition, mood, and function. Lower limb pain requires prioritized mobility preservation strategies. Findings support phenotype-specific pain management to reduce disability burden.

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中国中老年人疼痛模式：潜在分类分析。

慢性疼痛是全球老年人致残的主要原因，但中国中老年人群的疼痛分布模式尚不明确。使用潜在类分析（LCA），本研究确定了不同的疼痛定位模式及其与认知障碍、抑郁症状和功能限制的关联。方法：对CHARLS 2020数据库中9544名参与者进行横断面分析。LCA对疼痛模式进行分类，多变量逻辑回归分析了影响因素及其与认知障碍、抑郁症状和日常生活活动（ADL）障碍的关系。通过AIC/BIC和熵/后验概率（> 0.8）优化模型拟合。结果：确定了四种明显的类型：宽痛组（n = 935, 9.8%）、肩-腰痛组（n = 2426, 25.4%）、下肢痛组（n = 2568, 26.9%）和头-颈-胃痛组（n = 3615, 37.9%）。分析显示，疼痛位置模式与性别、收入以及多种合并症（包括血脂异常、胃病、癌症、哮喘、慢性肺病、中风、肾病、关节炎、情绪障碍、帕金森病和记忆相关疾病）等变量之间存在显著关联。此外，广泛性疼痛组与认知障碍、抑郁症状和ADL困难（包括BADL困难和IADL困难）有较强的相关性，下肢疼痛组与ADL障碍的可能性显著高于头颈胃痛组。结论：≥45岁的中国成年人的疼痛模式反映了不同的表型和不同的健康风险。广泛的疼痛组需要针对疼痛、认知、情绪和功能的综合干预。下肢疼痛需要优先的活动能力保护策略。研究结果支持表型特异性疼痛管理以减轻残疾负担。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.