Persistent pain is a risk factor for frailty: a systematic review and meta-analysis from prospective longitudinal studies

Saraiva, Marcos Daniel; Suzuki, G; Lin, Sumika Mori; Andrade, Daniel Ciampi de; Jacob‐Filho, Wilson; Suemoto, Cláudia Kimie

doi:10.1093/ageing/afy104

Cited by 71 publications

(57 citation statements)

References 26 publications

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“…Poorly managed pain is associated with impaired activities of daily living, decreased ambulation and cognitive impairment [26], with recent evidence suggesting worsening frailty and increase in incident frailty [11]. A meta-analysis of cross-sectional study data identified a strong association between pain related fear and disability [27], but inferences about the direction of the relationship could not be made.…”

Section: Discussionmentioning

confidence: 99%

“…This was an important finding as it suggested that interventions targeting pain might have the potential to attenuate frailty trajectories and thereby lessen disability. However, in this review [11], and an earlier review of cross-sectional studies [6], it was evident that the impact of pain on the day-to-day lives of older people with different severity grades of frailty had not been investigated as the assessment tools were predominantly single item measures to identify the presence of pain or pain severity.…”

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confidence: 99%

“…A recent systematic review that included five longitudinal studies involving 13,120 participants with mean ages of between 59 to 85 years old [11] reported that people with persistent pain at baseline had twice the risk of developing frailty during follow-up between three and eight years. This was an important finding as it suggested that interventions targeting pain might have the potential to attenuate frailty trajectories and thereby lessen disability.…”

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confidence: 99%

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A Cross-Sectional Study of the Impact of Pain in Older People with Frailty: Findings from the Community Ageing Research 75+ (CARE75+) Study

2019

Adv Geriatr Med Res

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confidence: 99%

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A Cross-Sectional Study of the Impact of Pain in Older People with Frailty: Findings from the Community Ageing Research 75+ (CARE75+) Study

2019

Adv Geriatr Med Res

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“…Participants identi ed as having any pain were also asked the following question: "Did the pain occur on most days in the past three months?". A negative answer de ned sporadic pain, while a positive answer de ned persistent pain [24,25]. We further investigated participants with persistent pain using the multidimensional Geriatric Pain Measure [26,27].…”

Section: Clinical Assessmentmentioning

confidence: 99%

Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

Saraiva

Rangel

Cunha

et al. 2020

Preprint

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Background: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of older adults in Brazil, to collect data both on healthy aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. Methods: The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every three years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least ten years.Results: We included 1,336 participants with a mean age of 82±8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥3. According to our CGA-based model, the incidence of death in one year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion: The ProGERO study will provide detailed clinical data and explore the late-life trajectories of community-dwelling older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of healthy and pathological aging in older adults from LMICs.

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“…An association between suffering from CP and being classi ed as frail or pre-frail has been reported in several investigations [20,21]. It has also been reported that adults with CP participate in less PA than individuals with no pain [22].…”

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confidence: 90%

A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain in primary care: randomized controlled trial.

Otones

García

Sanz³

et al. 2020

Preprint

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Background Exercise have shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care. Methods Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups. Results The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (-0.19 95%CI(-0.33- -0.04)) and remained after three months follow-up (-0.21 95%CI(-0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after three months. Conclusions An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up. Study registration details: This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

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Persistent pain is a risk factor for frailty: a systematic review and meta-analysis from prospective longitudinal studies

Abstract: persistent pain was a risk factor for the development of frailty in a meta-analysis of longitudinal studies. Better understanding of the association between pain and frailty with proper evaluation of potential confounders could allow the development of targeted interventions.

Cited by 71 publications

References 26 publications

A Cross-Sectional Study of the Impact of Pain in Older People with Frailty: Findings from the Community Ageing Research 75+ (CARE75+) Study

A Cross-Sectional Study of the Impact of Pain in Older People with Frailty: Findings from the Community Ageing Research 75+ (CARE75+) Study

Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain in primary care: randomized controlled trial.

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