Persistent pain and frailty: a case for homeostenosis

J Am Geriatr Soc. 2012 Jan;60(1):113-7. doi: 10.1111/j.1532-5415.2011.03769.x. Epub 2011 Dec 8.

Abstract

Objectives: To compare the association between self-reported moderate to severe pain and frailty.

Design: Cross-sectional analysis of the Canadian Study of Health and Aging Wave 2.

Setting: Community.

Participants: Representative sample of persons aged 65 and older in Canada.

Measurements: Pain (exposure) was categorized as no or very mild pain versus moderate or greater pain. Frailty (outcome) was operationalized as the accumulation of 33 possible self-reported health attitudes, illnesses, and functional abilities, subsequently divided into tertiles (not frail, prefrail, and frail). Multivariable logistic regression assessed for the association between pain and frailty.

Results: Of participants who reported moderate or greater pain (35.5%, 1,765/4,968), 16.2% were not frail, 34.1% were prefrail, and 49.8% were frail. For persons with moderate or greater pain, the odds of being prefrail rather than not frail were higher by a factor of 2.52 (95% confidence interval (CI) = 2.13-2.99; P < .001). For persons with moderate or greater pain, the odds of being frail rather than not frail were higher by a factor of 5.52 (95% CI = 4.49-6.64 P < .001).

Conclusion: Moderate or higher pain was independently associated with frailty. Although causality cannot be ascertained in a cross-sectional analysis, interventions to improve pain management may help prevent or ameliorate frailty.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Canada / epidemiology
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Frail Elderly*
  • Geriatric Assessment / methods*
  • Humans
  • Incidence
  • Male
  • Pain / diagnosis*
  • Pain / epidemiology
  • Pain Management / methods*
  • Prevalence
  • Retrospective Studies
  • Self Report*
  • Severity of Illness Index