Pain and frailty among community-dwelling older people in Hong Kong

Abstract

Introduction. Pain and frailty are common geriatric syndromes and can lead to adverse health outcomes. This study aims to examine the association between pain and frailty in community-dwelling older adults in Hong Kong and to suggest a patient-centred intervention for frail older people with pain. Methods: Community-dwelling older adults aged ≥ 65 years were invited to attend a health check programme. Characteristics of pain were recorded, including the presence of pain, the total number of pain sites, the highest pain intensity, and the frequency of pain. The 5-item FRAIL scale was used to screen frailty. The Lawton instrumental activity of daily living (IADL) scale was used to assess independence. Handgrip strength of the dominant hand and walking speed for 6 meters were measured. Results: Of 445 older adults who attended the health check programme, 265 women and 64 men (mean age, 75 years) agreed to participate and were included for analysis. Of them, 123 (37.4%) reported persistent pain, 116 (35.5%) reported sporadic pain, and 90 (27.4%) reported no pain. Participants were classified as frail (n=47, 14.3%), prefrail (n=200, 60.8%), or robust (n=82, 24.9%). Comparing the combined frail and prefrail group with the robust group, frailty was independently associated with age (odds ratios [OR]=1.053, p=0.007), Lawton IADL (OR=0.602, p=0.004), and sporadic pain (OR=2.072, p=0.031), after adjusting for walking speed and handgrip strength. Conclusion: The prevalence of frailty is high among community-dwelling older adults in Hong Kong. Age, IADL, and sporadic pain are independently associated with frailty; only pain is amenable. Pain management may help prevent progression to frailty in older people.