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.

Pain and Frailty in Hospitalized Older Adults

Roberto Manfredini
Membro del Collaboration Group
;
Fabio Fabbian
Membro del Collaboration Group
;
Alfredo De Giorgi
Membro del Collaboration Group
;
2020

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.
2020
Ardoino, Ilaria; Franchi, Carlotta; Nobili, Alessandro; Mannuccio Mannucci, Pier; Corli, Oscar; Mannuccio Mannucci, Pier; Nobili, Alessandro; Pietrangelo, Antonello; Perticone, Francesco; Licata, Giuseppe; Violi, Francesco; Roberto Corazza, Gino; Corrao, Salvatore; Marengoni, Alessandra; Salerno, Francesco; Cesari, Matteo; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Franchi, Carlotta; Cortesi, Laura; Tettamanti, Mauro; Miglio, Gabriella; Tettamanti, Mauro; Cortesi, Laura; Ardoino, Ilaria; Novella, Alessio; Prisco, Domenico; Silvestri, Elena; Emmi, Giacomo; Bettiol, Alessandra; Mattioli, Irene; Biolo, Gianni; Zanetti, Michela; Bartelloni, Giacomo; Vanoli, Massimo; Grignani, Giulia; Alessandro Pulixi, Edoardo; Lupattelli, Graziana; Bianconi, Vanessa; Alcidi, Riccardo; Girelli, Domenico; Busti, Fabiana; Marchi, Giacomo; Barbagallo, Mario; Dominguez, Ligia; Beneduce, Vincenza; Cacioppo, Federica; Corrao, Salvatore; Natoli, Giuseppe; Mularo, Salvatore; Raspanti, Massimo; Zoli, Marco; Laura Matacena, Maria; Orio, Giuseppe; Magnolfi, Eleonora; Serafini, Giovanni; Simili, Angelo; Palasciano, Giuseppe; Ester Modeo, Maria; Di Gennaro, Carla; Domenica Cappellini, Maria; Fabio, Giovanna; Migone De Amicis, Margherita; De Luca, Giacomo; Scaramellini, Natalia; Cesari, Matteo; Dionigi Rossi, Paolo; Damanti, Sarah; Clerici, Marta; Leoni, Simona; Danuta Di Mauro, Alessandra; Di Sabatino, Antonio; Miceli, Emanuela; Vincenzo Lenti, Marco; Pisati, Martina; Caccia Dominioni, Costanza; Pontremoli, Roberto; Beccati, Valentina; Nobili, Giulia; Leoncini, Giovanna; Anastasio, Luigi; Carbone, Maria; Cipollone, Francesco; Teresa Guagnano, Maria; Rossi, Ilaria; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Delitala, Giuseppe; Berria, Maria; Delitala, Alessandro; Muscaritoli, Maurizio; Molfino, Alessio; Petrillo, Enrico; Giorgi, Antonella; Gracin, Christian; Zuccalà, Giuseppe; D'Aurizio, Gabriella; Romanelli, Giuseppe; Marengoni, Alessandra; Volpini, Andrea; Lucente, Daniela; Picardi, Antonio; Vespasiani Gentilucci, Umberto; Gallo, Paolo; Bellelli, Giuseppe; Corsi, Maurizio; Antonucci, Cesare; Sidoli, Chiara; Principato, Giulia; Arturi, Franco; Succurro, Elena; Tassone, Bruno; Giofrè, Federica; Grazia Serra, Maria; Antonietta Bleve, Maria; Brucato, Antonio; De Falco, Teresa; Fabris, Fabrizio; Bertozzi, Irene; Bogoni, Giulia; Victoria Rabuini, Maria; Prandini, Tancredi; Manfredini, Roberto; Fabbian, Fabio; Boari, Benedetta; DE GIORGI, Alfredo; Tiseo, Ruana; Paolisso, Giuseppe; Rosaria Rizzo, Maria; Catalano, Claudia; Borghi, Claudio; Strocchi, Enrico; Ianniello, Eugenia; Soldati, Mario; Schiavone, Silvia; Bragagni, Alessio; Sabbà, Carlo; Saverio Vella, Francesco; Suppressa, Patrizia; Michele De Vincenzo, Giovanni; Comitangelo, Alessio; Amoruso, Emanuele; Custodero, Carlo; Fenoglio, Luigi; Falcetta, Andrea; L Fracanzani, Anna; Tiraboschi, Silvia; Cespiati, Annalisa; Oberti, Giovanna; Sigon, Giordano; Peyvandi, Flora; Rossio, Raffaella; Colombo, Giulia; Agosti, Pasquale; Monzani, Valter; Savojardo, Valeria; Ceriani, Giuliana; Salerno, Francesco; Pallini, Giada; Montecucco, Fabrizio; Ottonello, Luciano; Caserza, Lara; Vischi, Giulia; Lucio Liberato, Nicola; Tognin, Tiziana; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Rozzini, Renzo; Falanga, Lina; Stella Pisciotta, Maria; Baffa Bellucci, Francesco; Buffelli, Stefano; Montrucchio, Giuseppe; Peasso, Paolo; Favale, Edoardo; Poletto, Cesare; Margaria, Carl; Sanino, Maura; Violi, Francesco; Perri, Ludovica; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Campiotti, Leonardo; Grossi, Alessandra; Davide Diprizio, Roberto; Bertolotti, Marco; Mussi, Chiara; Lancellotti, Giulia; Vittoria Libbra, Maria; Galassi, Matteo; Grassi, Yasmine; Greco, Alessio; Sciacqua, Angela; Perticone, Maria; Battaglia, Rosa; Maio, Raffaele; Stanghellini, Vincenzo; Ruggeri, Eugenio; Del Vecchio, Sara; Salvi, Andrea; Leonardi, Roberto; Damiani, Giampaolo; Capeci, William; Mattioli, Massimo; Pio Martino, Giuseppe; Biondi, Lorenzo; Pettinari, Pietro; Ghio, Riccardo; Dal Col, Anna; Minisola, Salvatore; Colangelo, Luciano; Cilli, Mirella; Labbadia, Giancarlo; Afeltra, Antonella; Marigliano, Benedetta; Elena Pipita, Maria; Castellino, Pietro; Zanoli, Luca; Gennaro, Alfio; Gaudio, Agostino; Saracco, Valter; Fogliati, Marisa; Bussolino, Carlo; Mete, Francesca; Gino, Miriam; Vigorito, Carlo; Cittadini, Antonio; Moreo, Guido; Prolo, Silvia; Pina, Gloria; Ballestrero, Alberto; Ferrando, Fabio; Gonella, Roberta; Cerminara, Domenico; Berra, Sergio; Dassi, Simonetta; Cristina Nava, Maria; Graziella, Bruno; Baldassarre, Stefano; Fragapani, Salvatore; Gruden, Gabriella; Galanti, Giorgio; Mascherini, Gabriele; Petri, Cristian; Stefani, Laura; Girino, Margherita; Piccinelli, Valeria; Nasso, Francesco; Gioffrè, Vincenza; Pasquale, Maria; Sechi, Leonardo; Catena, Cristiana; Colussi, Gianluca; Cavarape, Alessandro; Da Porto, Andea; Passariello, Nicola; Rinaldi, Luca; Berti, Franco; Famularo, Giuseppe; Tarsitani, Patrizia; Castello, Roberto; Pasino, Michela; Paolo Ceda, Gian; Giuseppe Maggio, Marcello; Morganti, Simonetta; Artoni, Andrea; Grossi, Margherita; Del Giacco, Stefano; Firinu, Davide; Costanzo, Giulia; Argiolas, Giacomo; Montalto, Giuseppe; Licata, Anna; Alessandro Montalto, Filippo; Corica, Francesco; Basile, Giorgio; Catalano, Antonino; Bellone, Federica; Principato, Concetto; Malatino, Lorenzo; Stancanelli, Benedetta; Terranova, Valentina; Di Marca, Salvatore; Di Quattro, Rosario; La Malfa, Lara; Caruso, Rossella; Mecocci, Patrizia; Ruggiero, Carmelinda; Boccardi, Virginia; Meschi, Tiziana; Ticinesi, Andrea; Nouvenne, Antonio; Minuz, Pietro; Fondrieschi, Luigi; Nigro Imperiale, Giandomenico; Pirisi, Mario; Paolo Fra, Gian; Sola, Daniele; Bellan, Mattia; Porta, Massimo; Riva, Piero; Quadri, Roberto; Larovere, Erica; Novelli, Marco; Scanzi, Giorgio; Mengoli, Caterina; Provini, Stella; Ricevuti, Laura; Simeone, Emilio; Scurti, Rosa; Tolloso, Fabio; Tarquini, Roberto; Valoriani, Alice; Dolenti, Silvia; Vannini, Giulia; Volpi, Riccardo; Bocchi, Pietro; Vignali, Alessandro; Harari, Sergio; Lonati, Chiara; Napoli, Federico; Aiello, Italia; Landolfi, Raffaele; Montalto, Massimo; Mirijello, Antonio; Purrello, Francesco; Di Pino, Antonino; E Cognome Del Primario, Nome; Ghidoni, Silvia; Salvatore, Teresa; Monaco, Lucio; Ricozzi, Carmen; Pilotto, Alberto; Indiano, Ilaria; Gandolfo, Federica
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