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Body weight, frailty, and chronic pain in older adults: a cross-sectional study.

ABSTRACT: BACKGROUND:There exists limited data on the association between unhealthy body weight and chronic pain, and whether this association is explained by frailty status of older adults. METHODS:We included older adults aged ≥65 years from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Chronic pain was defined by self-reported pain lasting for ≥3 months in the past year. Body mass index (BMI) was categorized as underweight, normal, overweight, and obese. Participants were dichotomized as frail or non-frail based on a validated frailty index calculated as the proportion of the number of deficits present to a total of 45 possible deficits ascertained in NHANES. We used modified Poisson regression models to estimate prevalence ratios (PRs) and their 95% confidence intervals (CIs). RESULTS:Of 3693 older participants, one in six (15.9%) experienced chronic pain, with higher prevalence among the underweight (24.6%) and obese (20.2%) group. Frailty versus non-frailty was independently associated with BMI (PR = 1.25, 95% CI = 1.16-1.36 for underweight; and PR = 1.15, 95% CI = 1.07-1.22 for obese), and chronic pain (PR = 2.84, 95% CI = 2.18-3.69). After adjustment for frailty, the association between BMI and chronic pain decreased from PR = 1.82 to 1.64 for the underweight and 1.41 to 1.33 for the obese group. We did not observe an interaction effect between frailty and BMI. CONCLUSIONS:Unhealthy body weight was associated with increased chronic pain and the associations were partially explained by frailty status of older adults. Our findings generate hypotheses for further investigations of the interplay of these chronic conditions in older adults.

SUBMITTER: Chen C

PROVIDER: S-EPMC6534872 | biostudies-other | 2019 May

REPOSITORIES: biostudies-other

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Body weight, frailty, and chronic pain in older adults: a cross-sectional study.

Chen Cheng C Winterstein Almut G AG Fillingim Roger B RB Wei Yu-Jung YJ

BMC geriatrics 20190524 1

<h4>Background</h4>There exists limited data on the association between unhealthy body weight and chronic pain, and whether this association is explained by frailty status of older adults.<h4>Methods</h4>We included older adults aged ≥65 years from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Chronic pain was defined by self-reported pain lasting for ≥3 months in the past year. Body mass index (BMI) was categorized as underweight, normal, overweight, and obese. Partic ...[more]

PMID: 31126233

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Project description:OBJECTIVES:To determine the prevalence of frailty and the association of sociodemographic characteristics, clinical aspects, and functional capacity with the frailty status of community-dwelling older adults from Curitiba, Southern Brazil. METHODS:This cross-sectional observational study included 1,716 participants aged ?60 years. Frailty was assessed using the Fried phenotype indicators of weakness, exhaustion, low activity, slowness, and weight loss. Sociodemographic characteristics, clinical aspects, and functional capacity and functionality were evaluated and compared between the sexes and the different frailty statuses (non-frail, prefrail, and frail). Multinomial logistic regression models were used to identify associations (p<0.05). RESULTS:A high prevalence of frailty (15.8%) and prefrailty (65.3%) were observed, and both were higher in female than in male individuals. The most predominant frailty criterion was weakness, followed by exhaustion. Compared with the non-frail elderly, the prefrail and frail elderly were older in age and presented more health problems, greater dependency for basic and instrumental activities of daily living, and reduced lower extremity strength performance and functional mobility. The highest proportion of illiterate individuals, individuals with 1-4 years of education, widowed individuals, polypharmacy, and possible cognition problems and diseases were seen in the frail elderly group. Moreover, the risk of being prefrail and frail was higher in those who were older and had more health problems, higher body mass index, and reduced lower extremity strength performance. Greater calf circumference and independence in activities of daily living were protective factors for prefrailty and frailty. Furthermore, lower functional mobility increased the chances of being frail. CONCLUSIONS:The prevalence of frailty was more pronounced in female than in male individuals, mainly because of a decline in force. Prefrailty was 4 times more prevalent than frailty, and the presence of health problems and reduced functional capacity increased the chances of being prefrail and frail.

Project description:OBJECTIVES:To explore the association between the number of teeth and frailty among older Chinese adults using a nationally representative sample. DESIGN:Cross-sectional analysis was carried out using the 2014 wave data from the Chinese Longitudinal Healthy Longevity Survey, which used a targeted random-sampling design. SETTING:This research was conducted in communities from nearly half of the counties and cities in 22 out of 31 provinces throughout China. PARTICIPANTS:Of the 6934 interviewees aged ?65 years, the final analysis included 3635 older adults who had completed the 2014 wave survey on the variables included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES:Outcome variables included frailty, measured by the Frailty Index, and number of teeth. Covariates included demographic characteristics (ie, age, sex, co-residence, marital status, years of education and financial support), body mass index (BMI) and health behaviours (ie, smoking, drinking and exercise). A univariate logistic regression was used to test the factors associated with frailty. A multiple logistic regression model was used, using the frailty score as the dependent variable and the number of teeth together with significant covariates as the independent variables. RESULTS:The prevalence of frailty was 27.68%. The mean number of teeth present was 9.23 (SD=10.03). The multiple logistic regression showed that older adults' demographic variables, health behaviours, BMI, tooth number and chewing pain were significantly associated with frailty. After adjusting for the covariates, older adults with fewer teeth had significantly higher odds of frailty than those with 20 or more teeth (no teeth: OR=2.07, 95% CI 1.53 to 2.80; 1 to 10 teeth: OR=1.77, 95% CI 1.31 to 2.38), except for older adults with 11 to 20 teeth (OR=1.30, 95% CI 0.93 to 1.82). CONCLUSIONS:The presence of fewer teeth is significantly associated with frailty status among older Chinese adults. Future studies are needed to explain the specific mechanisms underlying how oral health status is associated with frailty.

Dataset Information

Body weight, frailty, and chronic pain in older adults: a cross-sectional study.

Publications

Body weight, frailty, and chronic pain in older adults: a cross-sectional study.

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