ArticleAging clinical and experimental research2025
From age to frailty: redefining chronic pain characterization.
Article in Aging clinical and experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic pain in older adults is highly prevalent, multifactorial, and often associated with greater intensity, multisite involvement, and functional impairment. Despite its burden, it remains frequently underdiagnosed and undertreated. Chronological age alone does not adequately capture biological vulnerability or interindividual variability in pain expression.
aimsTo examine the associations of frailty, an indirect marker of biological age, and chronological age with chronic pain characteristics.
methodsWe conducted a cross-sectional study including 455 adults (≥18 years) recruited from primary care. Thirty-three pain characteristics were assessed through structured interviews. Frailty was quantified using a 31-item Frailty Index based on the deficit accumulation model. Associations of frailty, chronological age, and sex with each pain variable were analyzed using multivariable linear and logistic regression models.
resultsMost pain characteristics were more consistently associated with frailty than with chronological age, although effect sizes were modest (sr2 typically 1–5%). Frailty correlated with greater pain intensity (sr 0.23, r2 5.3%), higher frequency (sr 0.10, r2 1.1%), and continuous or mixed-type pain (OR 0.97, 95% CI 0.95–0.99). In contrast, chronological age primarily predicted temporal aspects, including pain duration, diagnostic delay, and time to first analgesic prescription. Age and frailty showed opposite directions of association for certain domains, such as accompanying symptoms and daily pain duration.
conclusionFrailty provides complementary information to chronological age in characterizing chronic pain. Integrating frailty assessment into routine pain evaluation may enable more individualized management, enhance pain control, and reduce age-related disparities in clinical care.
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