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Study explores link between pain and frailty

By Jane Lewis 
Pain is associated with an increased risk and intensity of frailty in older men and women, according to new research published in the Journals of Gerontology: Medical Sciences

It has been suggested that pain potentially accelerates declines in health and functioning, wrote a UK research team, who set out to examine the association between self-reported pain and the development or worsening of frailty among older men and women. 

‘Frailty is increasingly being recognised as a marker of increased vulnerability to stressors and associated with adverse health outcomes, including disability, institutionalisation and death,’ Associate Professor Benny Katz, Director of Geriatric Medicine at St Vincent’s Hospital, Melbourne, told Pain Management Today. ‘Frail individuals are more vulnerable to the negative impacts of pain, as well as adverse treatment effects.’ 

The study was based on data from the English Longitudinal Study of Ageing, a nationally representative study of men and women aged 50 years and over (mean age, 64.5 years) living in private households. Among 5316 participants who provided data at both Wave 2 and Wave 6 of the study (two to three years and 10 to 11 years after the initial survey, respectively), those who reported moderate to severe pain at Wave 2 were significantly more likely to be frail at Wave 6. This association persisted after adjustment for age, gender, body mass index, lifestyle factors, depressive symptoms and occupational class and/or net wealth level. Participants reporting pain were also more likely to develop worsening frailty, as assessed using the Frailty Index (a widely used 51-item instrument), compared with those without pain. 

‘This is an important finding and further reason for ensuring that older people receive adequate pain management,’ commented Associate Professor Katz. 

The strength of the association between pain and new frailty increased with the severity of pain, suggesting a dose–response relationship, the researchers reported. Discussing the possible mechanism linking pain and frailty, they theorised that pain may ‘create a state of vulnerability to stressors,’ thereby increasing the risk of developing, or worsening, frailty, and ‘the more pain a person suffers, potentially the greater the stress experienced and therefore the greater risk of frailty.’ 

These findings ‘suggest potential opportunities for targeting individuals suffering from pain for interventions to reduce the occurrence of frailty,’ they concluded.
J Gerontol A Biol Sci Med Sci 2017; 72: 403-409. 

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