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Persistent pain is a risk factor for frailty: a systematic review and meta-analysis from prospective longitudinal
Marcos Daniel Saraiva1, Gisele Sayuri Suzuki1, Sumika Mori Lin1
1Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, CEP, Brazil.
Background:
pain is prevalent in frail older adults; however, the association of pain and frailty has not been evaluated yet by a systematic assessment of prospective longitudinal studies.
Objective:
we aimed to assess the association of persistent pain as a risk factor for frailty incidence, using data from longitudinal studies in a systematic review and meta-analysis.
Methods:
publications were identified using a systematic search on PubMed, Embase, Cochrane Library and clinicaltrials.gov databases from inception to October 2017. Since heterogeneity across studies was high, we used random-effects meta-analysis to calculate the pooled relative risk for the association between persistent pain and the incidence of frailty. We investigated sources of heterogeneity among studies using meta-regression and stratified analyses.
Results:
we included five prospective longitudinal studies with 13,120 participants (46% women, mean age from 59 to 85 years old). Participants with persistent pain at baseline had twice the risk of developing frailty during the follow-up (pooled RR = 2.22, 95% CI = 1.14-4.29). No variables were related to study heterogeneity in sensitivity analyses.
Conclusion:
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.
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