Effects Of Chronic Pain On Frailty In Elderly Patients With Metabolic Syndrome In The Community:Mediators And Interactions Of Sleep Disturbances Chronic In Elderly Patients With Metabolic Syndrome

Objectives1.To investigate the current status of debilitation in elderly patients with metabolic syndrome and to analyze the influencing factors;2.To investigate whether the mediating effect of sleep disturbance between chronic pain and debilitation is significant in patients with metabolic syndrome;3.To investigate the effect of the interaction between chronic pain and sleep disturbance on frailty in patients with metabolic syndrome.Methods1.This study adopts the random cluster sampling method to select permanent elderly residents aged 65 and above who participated in physical examination from October 2021 to December 2021 in Tangwang Community of Yangzhou City as the research objects.2.In this study,a self-designed general data survey and evaluation form was used to evaluate the socio-demographic and disease-related data of the elderly in the community.Blood test information and physical examination data were used to assess the presence of metabolic syndrome;Chronic pain was assessed by a concise pain assessment scale.Sleep disturbances were assessed using the Pittsburgh Sleep Quality Index.Frailty Scale were evaluated using the frail evaluation scale.3.Use Epidata3.1 to input and organize data.STATA15.0 was used for data analysis.Statistical methods include descriptive analysis,nonparametric test,single factor analysis,multiple linear regression,mediating effect Z test and multiplicative interaction test.Results1.Analysis of frailty status and influencing factors in elderly patients with metabolic syndromeThe prevalence of frailty in the elderly with metabolic syndrome was 22.5%.Univariate analysis showed that age,educational level,smoking,drinking,self-rated health status,chronic pain,and sleep disturbances were the factors influencing the development of frailty in elderly patients with metabolic syndrome.Multivariate regression results showed that age,education level,alcohol consumption,self-rated health,chronic pain and sleep disturbances were the factors influencing the development of frailty in elderly patients with metabolic syndrome.2.Analysis of the mediating effect of sleep disturbances on the occurrence of chronic pain and frailtyPain was positively associated with the onset of frailty(OR=2.03,95%CI=1.27-3.26).The relationship between pain and sleep disturbances was significant(OR=2.07,95%CI=1.36-3.15).The effect of pain on the onset of frailty was reduced,but was still significant after the inclusion of sleep disturbances(OR=1.82,95%CI=1.12-2.95).Relationship between sleep disturbances and the development of frailty These results suggest that sleep disturbances mediate the relationship between chronic pain and frailty.The Z-test showed a significant mediating effect(z=3.95 p<0.05).3.The effect of the interaction between chronic pain and sleep on frailtyThe risk of frailty was 1.16 times higher in older adults with chronic pain than in those without chronic pain(95%CI=0.61-2.01),1.13 times higher in older adults with sleep disturbance than in those without sleep disturbance(95%CI=0.48-2.65),and 3.47 times higher in older adults with both chronic pain and sleep disturbance than in those without both chronic pain and sleep disturbance(95%CI=0.48-2.65).The risk of frailty in older adults with both chronic pain and sleep disturbance was 3.47 times higher(95%CI=0.48-2.65)than in older adults with neither chronic pain nor sleep disturbance.This suggests a multiplicative interaction between chronic pain and sleep disturbance,which has a significant effect on frailty,p multiplication interaction=0.033.ConclusionIn the process of prevention and treatment of frailty in elderly patients with metabolic syndrome,it is necessary to focus on the evaluation and intervention of chronic pain and sleep disturbance.