The association of painful and non-painful morbidities with frailty: a cross sectional analysis of a cohort of community dwelling older people in England

Chaplin, W. J.; Lewis, H. R.; Shahtaheri, S. M.; Millar, B. S.; McWilliams, D. F.; Gladman, J. R. F.; Walsh, D. A.

Abstract

Introduction
The association between chronic pain and frailty might indicate that pain is an independent driver of frailty but might alternatively be explained by inclusion within frailty identification tools of morbidities that commonly lead to chronic pain. This research examines the extent to which the association of pain with frailty might be attributed to morbidities.

Methods
A cross-sectional analysis of older people in a UK cohort with or at risk of musculoskeletal problems or frailty (Investigating Musculoskeletal Health and Wellbeing study), used multivariable logistic regression and Z-tests to assess the degrees of associations of pain (McGill Pain Rating Index), and painful and non-painful morbidity counts with frailty (modified FRAIL questionnaire).

Results
Data were from 2,185 participants, 56% female, median age 73 (range 60 to 96) years. 430 (20%) participants were classified as frail. In a fully adjusted standardised model, pain (aOR 2.07 (95%CI 1.83 to 2.33) and ‘any’ morbidity aOR (1.74 (95%CI 1.54 to 1.97) were both significantly associated with frailty. When morbidity was subclassified as painful or non-painful, painful (aOR 1.48 (95%CI 1.30 to 1.68) and non-painful (aOR1.39 (95%CI 1.24 to 1.56)) morbidities each were associated with frailty, as also was pain (aOR 2.07 (95%CI 1.83 to 2.34, p < 0.001).

Conclusions
Pain is associated with frailty, over and above any effect of painful and non-painful morbidities. This forms the justification for future research which focuses on pain management in the identification, prevention, and treatment of frailty.

Citation

Chaplin, W. J., Lewis, H. R., Shahtaheri, S. M., Millar, B. S., McWilliams, D. F., Gladman, J. R. F., & Walsh, D. A. (2024). The association of painful and non-painful morbidities with frailty: a cross sectional analysis of a cohort of community dwelling older people in England. BMC Geriatrics, 24, Article 158. https://doi.org/10.1186/s12877-023-04602-w

• Journal Article Type: Article
• Acceptance Date: Dec 14, 2023
• Online Publication Date: Feb 15, 2024
• Publication Date: Feb 15, 2024
• Deposit Date: Mar 1, 2024
• Publicly Available Date: Mar 5, 2024
• Journal: BMC Geriatrics
• Electronic ISSN: 1471-2318
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Article Number: 158
• DOI: https://doi.org/10.1186/s12877-023-04602-w
• Keywords: Chronic pain, Frailty, Older people, Morbidities
• Public URL: https://nottingham-repository.worktribe.com/output/31452997
• Publisher URL: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-04602-w