Pain, frailty and comorbidity on older men: the CHAMP study.
Intrusive pain is likely to have a serious impact on older people with limited ability to respond to additional stressors. Frailty is conceptualised as a functional and biological pattern of decline accumulating across multiple physiological systems, resulting in a decreased capacity to respond to additional stressors. We explored the relationship between intrusive pain, frailty and comorbid burden in 1705 community-dwelling men aged 70 or more who participated in the baseline phase of the CHAMP study, a large epidemiological study of healthy ageing based in Sydney, Australia. 9.4% of men in the study were frail (according to the commonly-used Cardiovascular Health Study frailty criteria).Using a combination of self-report and clinical measures, we found an association between frailty and intrusive pain that remained after accounting for demographic characteristics, number of comorbidities, self-reported depressed mood and arthritis (adjusted odds ratio 1.7 (95% confidence interval (CI) 1.1-2.7), p=0.0149). The finding that adjusting for depressed mood, but not a history of arthritis, attenuated the relationship between frailty and intrusive pain points to a key role for central mechanisms. Additionally, men with the highest overall health burden (frail plus high comorbid burden) were most likely to report intrusive pain (adjusted odds ratio 3.0 (95% CI 1.6-5.5), p=0.0004). These findings provide support for the concept that intrusive pain is an important challenge for older men with limited capacity to respond to additional physical stressors. To our knowledge, this is the first study to explore specifically the relationship between pain and frailty.
Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Concord, 2139 NSW, Australia School of Public Health, University of Sydney, NSW, Australia ANZAC Research Institute, Concord Hospital, University of Sydney, NSW, Australia Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, NSW, Australia University of Sydney Pain Management Research Institute, Royal North Shore Hospital, Australia Service of Geriatric Medicine and Rehabilitation, CHUV, Lausanne, Switzerland.
Fiona M
FM
Blyth
Stephane
S
Rochat
Robert G
RG
Cumming
Helen
H
Creasey
David J
DJ
Handelsman
David G Le
DGL
Couteur
Vasi
V
Naganathan
Philip N
PN
Sambrook
Markus J
MJ
Seibel
Louise M
LM
Waite
D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors