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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2010.tde-25112010-104725
Document
Author
Full name
Adriana Maria Barsante Santos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2010
Supervisor
Committee
Marques, Amelia Pasqual (President)
Driusso, Patricia
João, Silvia Maria Amado
Title in Portuguese
Prevalência da fibromialgia em população de idosos e relação com a osteoporose
Keywords in Portuguese
Dor
Fibromialgia
Idosos
Osteoporose
Prevalência
Qualidade de vida
Abstract in Portuguese
Introdução: Fibromialgia (FM) é uma síndrome reumática caracterizada por dor musculoesquelética difusa e crônica e pontos dolorosos específicos à palpação, os tender points (tp), associada à fadiga e rigidez matinal, podendo causar impacto na capacidade funcional e qualidade de vida. Sua prevalência varia de 0,5 a 5% na população adulta. Frequentemente a FM é associada à reduzida atividade física e sedentarismo e, este fato pode levar à baixa densidade óssea e maior risco de desenvolver a osteoporose (OP), doença esquelética sistêmica, caracterizada por baixa densidade mineral óssea e deteriorização da microarquitetura óssea, o que aumenta o risco de fraturas. Objetivos: avaliar a prevalência da FM e dor difusa crônica na população idosa e a sua associação com a OP. E, avaliar a qualidade de vida desta população, usando o Questionário sobre o Impacto da Fibromialgia (QIF) e correlacioná-lo com tp e limiar de dor. Casuística e Métodos: Foram avaliados 361 indivíduos, 64% mulheres e 36% homens, média de idade de 73,3 ± 5,7 anos. O protocolo incluiu características demográficas, avaliação da dor (tempo e local), limiar de dor dos 18 tp com o dolorímetro, grau de atividade física, QIF e densitometria óssea. A estatística foi análise descritiva, teste Qui-quadrado de homogeneidade, ANOVA, testes não-paramétricos de Kruskal-Wallis e Correlação de Spearman, ao nível de significância de 5%. Resultados: A partir da intensidade da dor, os indivíduos foram classificados em quatro grupos: Sem Dor - SD (n=100), Dor Localizada - DL (n=190), Dor Difusa Crônica DDC (n=51) e Fibromialgia FM (n=20). A prevalência de FM foi 5,5% (IC 95%: 5,4 - 5,7) e de DDC foi 14,1% (IC 95%: 10,5% - 17,7%). A freqüência de DL foi 52,6% e SD; 27,7%. Não houve associação significativa de FM e OP (p=0,390). Houve alta freqüência de osteopenia e OP em todos os grupos (>33%). Os escores do QIF foram mais altos nos grupos FM (44,5), DDC (31,4) seguidos pelos DL (18,1) e SD (5,5) (p<0,001). Houve correlação positiva entre os domínios do QIF e nº de tp (p<0,05), e correlação negativa do QIF e limiar de dor (p<0,05). Conclusões: A prevalência de FM na população idosa do Butantã, São Paulo, foi ligeiramente mais alta e DDC semelhante a outros estudos. O impacto na qualidade de vida foi mais intenso no grupo FM, seguido pelo DDC, DL e SD. Alto nº de tp e baixo limiar de dor são associados com os sintomas da FM. Não houve associação FM e OP
Title in English
Prevalence of fibromyalgia in elderly subjects and relation to osteoporosis
Keywords in English
Elderly
Fibromyalgia
Osteoporosis
Pain
Prevalence
Quality of Life
Abstract in English
Background: Fibromyalgia (FM) is a rheumatic syndrome characterized by chronic widespread pain, tender points (tp), fatigue and morning stiffness. Functional Disability and negative impact in the quality of life are frequent. Fibromyalgia prevalence varies from 0,5% to 5% in the adult population. FM is often associated with reduced physical activity and sedentary, and this may lead to low bone density and increased risk of developing Osteoporosis (OP), a skeletal disorder characterized by low bone mineral density and deterioration of bone microarchitecture, which increase risk of fracture. Objectives: To assess the prevalence of FM and Chronic Widespread Pain in the elderly population and the association of FM and OP. And, to assess the quality of life in this population, using the Fibromyalgia Impact Questionnaire (FIQ), and correlate it with tp and with pain threshold. Methods: We evaluated 361 individuals, 64% women and 36% men, mean age 73,3 ± 5,7 years. The protocol included demographic characteristics, pain assessment (duration and location), pain threshold of the 18 tp with dolorimeter, level of physical activity, FIQ and bone densitometry. The statistics was descriptive analysis, chi-square test of homogeneity, ANOVA, nonparametric tests of Kruskal-Wallis and Spearman Correlation, the significance level of 5%. Results: From the intensity of pain, subjects were classified into four groups: No Pain - NP (n=100), Regional Pain RP (n=190), Chronic Widespread Pain CWP (n=51) and Fibromyalgia FM (n=20). The prevalence of FM was 5,5% (95% CI: 5,4 5,7) and CWP was 14,1% (95% CI: 10,5% - 17,7%). The frequency of RP was 52,6% and the NP was 27,7%. There was no significant association between FM and OP (p=0,390). There was a high frequency of osteopenia and OP in all groups (>33%). Scores of FIQ were higher in those with FM (44,5), CWP (31,4), followed by RP (18,1) and NP (5,5) (p<0,001). There was a positive correlation between the domains of the FIQ and number of tp (p<0,05), and a negative correlation of FIQ and pain threshold (p<0,05). Conclusions: The prevalence of FM in the elderly population of Butantã, São Paulo, Brazil, was slighter higher compared to previous literature studies and CWP was similar. FM had the most impact on the quality of life, followed by CWP, RP and NP. Higher number of tp and lower threshold of pain were associated with symptoms of FM. There was no association FM and OP
 
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Publishing Date
2010-11-26
 
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