Pain and Frailty in Hospitalized Older Adults
Ilaria Ardoino, Carlotta Franchi, Alessandro Nobili, Pier Mannuccio Mannucci, Oscar Corli, REPOSI Investigators, Pier Mannuccio Mannucci, Alessandro Nobili, Antonello Pietrangelo, Francesco Perticone, Giuseppe Licata, Francesco Violi, Gino Roberto Corazza, Salvatore Corrao, Alessandra Marengoni, Francesco Salerno, Matteo Cesari, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Carlotta Franchi, Laura Cortesi, Mauro Tettamanti, Gabriella Miglio, Mauro Tettamanti, Laura Cortesi, Ilaria Ardoino, Alessio Novella, Domenico Prisco, Elena Silvestri, Giacomo Emmi, Alessandra Bettiol, Irene Mattioli, Gianni Biolo, Michela Zanetti, Giacomo Bartelloni, M. Vanoli, Giulia Grignani, E.A. Pulixi, Graziana Lupattelli, Vanessa Bianconi, Riccardo Alcidi, Domenico Girelli, Fabiana Busti, Giacomo Marchi, Mario Barbagallo, Ligia J. Domínguez, Vincenza Beneduce, Federica Cacioppo, Salvatore Corrao, Giuseppe Natoli, Salvatore Mularo, Massimo Raspanti, Marco Zoli, Maria Laura Matacena, Giuseppe Orio, Eleonora Magnolfi, Giovanni Serafini, Angelo Simili, Giuseppe Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia Scaramellini, Matteo Cesari, Paolo Rossi, Sarah Damanti, Marta Clerici, Simona Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela Miceli, Marco Vincenzo Lenti, Martina Pisati, Costanza Caccia Dominioni, Roberto Pontremoli, Valentina Beccati, Alessandro Nobili, Giovanna Leoncini, Luigi Anastasio, Maria Carbone, Francesco Cipollone, Maria Teresa Guagnano, Ilaria Rossi, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Giuseppe Delitala, Maria Berria, Alessandro Delitala, Maurizio Muscaritoli, Alessio Molfino, Enrico Petrillo, Antonella Giorgi, Christian Gracin, Giuseppe Zuccalà, Gabriella D’Aurizio
Abstract
INTRODUCTION: Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. METHODS: In light of this knowledge gap, 3577 acutely hospitalized patients 65 years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. RESULTS: The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38-2.07). Somatic pain (OR = 1.59, 95% CI 1.23-2.07) and widespread pain (OR = 1.60, 95% CI 0.93-2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28-0.85). CONCLUSIONS: Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people.