ArticleInternational journal of nursing studies2021
Associations between symptoms of pain, insomnia and depression, and frailty in older adults: A cross-sectional analysis of a cohort study.
Article in International journal of nursing studies, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Effects of different sleep disorders on frailty in the elderly: a systematic review and meta-analysis of observational studies.Sleep & breathing = Schlaf & Atmung · 2023Pooled it
- Association between insomnia and frailty in older population: A meta-analytic evaluation of the observational studies.Brain and behavior · 2023Pooled it
- Symptom Clusters and Frailty Among Older Adults With and Without Cancer: Insights From Two Cross-Sectional Studies.Nursing & health sciences · 2026Article
- Characterising Pain in Post-COVID-19 Syndrome: An Observational Study of Intensity and Sensitivity.Diagnostics (Basel, Switzerland) · 2026Article
- Interpreting higher-order dependence in multimorbidity using cohort data: A partial information decomposition approach.PLoS computational biology · 2026Article
- The association between sleep quality and postoperative pain after half-impacted mandibular third molar extraction: comparison of three statistical models.BMC oral health · 2026Article
- Association between chronic pain and frailty among Chinese adults aged ≥ 60 years: a cross-sectional study.Internal and emergency medicine · 2026Article
- Performance-Based and Self-Reported Frailty in Older Adults with or Without Fibromyalgia.European journal of investigation in health, psychology and education · 2026Article
- Quantifying the population-level impact of insomnia on dementia among older adults in the United States.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Sleep characteristics and risk factors in patients of insomnia comorbid with anxiety.BMC psychology · 2026Article
- Depression and Longitudinal Frailty Trajectories in Middle-Aged and Older Adults with Chronic Pain: A 8-Year National Cohort Study in China.Psychology research and behavior management · 2026Article
- Development and Validation of a Risk Screening Model for Depressive Symptoms in Older Inpatients: A Cross-Sectional Study.Clinical interventions in aging · 2026Article
- Interactive effect of sleep duration and trouble sleeping on frailty in chronic kidney disease: findings from NHANES, 2005-2018.Renal failure · 2025Article
- Preoperative Factors Associated With Falls Following Total Hip Arthroplasty in Older Adults.ACR open rheumatology · 2025Article
- Acupuncture for insomnia.The Cochrane database of systematic reviews · 2025Article
- Longitudinal association between frailty and pain in three prospective cohorts of older population.The journal of nutrition, health & aging · 2025Article
- Temporal association between chronic pain and frailty occurrence, and the modifiable role of a healthy lifestyle in Chinese middle-aged and older population: a community based, prospective cohort study.Aging clinical and experimental research · 2025Article
- Cross-sectional and longitudinal trajectory analyses of sleep duration and frailty among middle-aged and older Chinese adults.Scientific reports · 2025Article
- Depressive symptoms and frailty, effects of social distancing and isolation in older adults.Investigacion y educacion en enfermeria · 2025Article
- Building Consensus on the Relevant Criteria to Screen for Depressive Symptoms Among Near-Centenarians and Centenarians: Modified e-Delphi Study.JMIR aging · 2025Article
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundFrailty is prevalent in older adults and has adverse effects on multiple health outcomes. Pain, insomnia, and depressive symptoms are commonly seen and treatable symptoms in older adults and are associated with frailty. However, it is unknown whether these symptoms are independently associated with frailty and how they interact with each other creating a greater impact on frailty than individual symptoms. It is important to understand these associations for nurses to provide high-quality patient-centered care for older adults with frailty.
objectivesTo determine independent associations of pain, insomnia, and depressive symptoms with frailty and examine their synergistic impact on frailty among older adults.
designA cross-sectional analysis of a cohort study.
settingCommunities in the United States.
participantsCommunity-dwelling older adults from the National Health and Aging Trend Study (N = 7,609), a nationally representative survey of Medicare Beneficiaries in the United States.
methodsFrailty status was determined by five criteria of the Physical Frailty Phenotype: exhaustion, low physical activity, weakness, slowness, and shrinking. Pain was determined by self-reports of bothersome pain in the last month. Insomnia included self-reports of difficulty initiating sleep and difficulty maintaining sleep. Depressive symptom was assessed by the Patient Health Questionnaire-2. Logistic regression models were used adjusting for sociodemographic, health-related and behavioral covariates.
resultsThe sample was mainly under 80 years old (72%), female (57%), and non-Hispanic White (81%). Approximately 53% experienced bothersome pain, 11% had difficulty initiating sleep, 6% had difficulty maintaining sleep, and 15% had depressive symptom; 46% were pre-frail and 14% were frail. Independent associations with pre-frailty and frailty were found in pain (odds ratio [OR]: 1.81, 95% CI: 1.60, 2.04), difficulty initiating sleep (OR: 1.23, 95% CI: 1.04, 1.46) and depressive symptom (OR: 2.29, 95% CI: 1.85, 2.84). Interaction terms between pain and depressive symptom (OR: 1.87, 95% CI: 1.14, 3.07), and between difficulty initiating sleep and depressive symptom (OR: 2.66, 95% CI: 1.15, 6.13) were significant, suggesting a synergistic impact on pre-frailty and frailty.
conclusionsPain, difficulty initiating sleep, and depressive symptoms are independent risk factors of frailty and may have a synergistic impact on frailty. Interventions should be developed to address these symptoms to reduce the adverse effects of frailty.
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