Risk Factors for Neuropathic Pain in Middle-Aged and Elderly People: A Five-Year Longitudinal Cohort in the Yakumo Study

• Published in: Pain medicine (Malden, Mass.) Mass.), 2020-08, Vol.21 (8), p.1604-1610
• Main Authors: Imagama, Shiro, Ando, Kei, Kobayashi, Kazuyoshi, Nakashima, Hiroaki, Seki, Taisuke, Hamada, Takashi, Machino, Masaaki, Ota, Kyotaro, Tanaka, Satoshi, Morozumi, Masayoshi, Kanbara, Shunsuke, Ito, Sadayuki, Ishiguro, Naoki, Hasegawa, Yukiharu
• Format: Article
• Language: English
• Subjects: Aged; Body mass index; Cohort Studies; Female; Gait; Health aspects; Humans; Kyphosis; Longitudinal Studies; Low back pain; Male; Middle age; Middle Aged; Middle aged persons; Muscle strength; Neuralgia; Neuralgia - epidemiology; Older people; Osteoporosis; Pain; Prospective Studies; Quality of Life; Risk Factors; Sarcopenia; Statistics
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1093/pm/pnaa036

Abstract Objective To determine the risk factors for new neuropathic pain (NeP) after five years in healthy middle-aged and elderly volunteers. Design Prospective longitudinal cohort study (Yakumo study). Setting Clinical evaluation in a health checkup. Subjects A total of 366 people (male N = 146, female N = 220, average age = 63.5 years) who did not have NeP in 2013 were examined. Methods NeP was diagnosed based on a painDETECT questionnaire score ≥13. Body mass index (BMI), comorbidity, low back pain (LBP), sciatica, physical ability, grip and back muscle strength, osteoporosis, sarcopenia, frailty, spinal alignment, and quality of life (QOL) with the SF36 in 2013 were compared between NeP(+) and NeP(-) subjects in 2018 using multivariate logistic regression analysis. Results The NeP(+) rate in 2018 was 5.2%, with no significant differences in age and gender. NeP(+) subjects had significantly lower BMI, severe sciatica, poor gait ability, higher rates of osteoporosis and sarcopenia, greater lumbar kyphosis and spinal inclination, and poorer mental health in 2013. Poor gait ability (odds ratio [OR] = 8.05), low BMI (OR = 2.31), lumbar kyphosis (OR = 1.38), low percentage of the young adult mean (OR = 1.15), and low mental QOL (OR = 1.06) were identified as significant and independent risk factors for new NeP after five years. Conclusions This longitudinal cohort study identified five independent risk factors for development of new NeP after five years, with related factors of spinal inclination, sarcopenia, and sciatica. New NeP may be prevented by intervention or treatment of these factors at an early stage in relatively healthy middle-aged and elderly people.