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Chronic widespread pain is associated with worsening frailty in European men

Wade, KF and Lee, DM and Mcbeth, J and Ravindrarajah, R and Gielen, E and Pye, SR and Vanderschueren, D and Pendleton, N and Finn, JD and Bartfai, G and Casanueva, FF and Forti, G and Giwercman, A and Huhtaniemi, IT and Kula, K and Punab, M and Wu, FCW and O'neill, TW (2016) Chronic widespread pain is associated with worsening frailty in European men. Age and Ageing, 45 (2). pp. 268-274. ISSN 0002-0729

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Abstract

© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. Background: we hypothesised that chronic widespread pain (CWP), by acting as a potential stressor, may predispose to the development of, or worsening, frailty. Setting: longitudinal analysis within the European Male Ageing Study (EMAS). Participants: a total of 2,736 community-dwelling men aged 40-79. Methods: subjects completed a pain questionnaire and shaded a manikin, with the presence of CWP defined using the American College of Rheumatology criteria. Physical activity, smoking, alcohol consumption and depression were measured. Repeat assessments took place a median of 4.3 years later. A frailty index (FI) was used, with frail defined as an FI > 0.35. The association between CWP at baseline and the new occurrence of frailty was examined using logistic regression; the association between CWP at baseline and change in FI was examined using negative binomial regression. Results: at baseline, 218 (8.3%) men reported CWP. Of the 2,631 men who were defined as non-frail at baseline, 112 (4.3%) were frail at follow-up; their mean FI was 0.12 (SD 0.1) at baseline and 0.15 (SD 0.1) at follow-up, with a mean change of 0.03 (SD 0.08) P ≤ 0.001. Among men who were non-frail at baseline, those with CWP were significantly more likely to develop frailty. After adjustment for age and centre, compared with those with no pain, those with CWP at baseline had a 70% higher FI at follow-up; these associations remained significant after further adjustment for smoking, body mass index, depression, physical activity and FI at baseline. Conclusion: the presence of CWP is associated with an increased risk of frailty in older European men.

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