Relationship Between Chronic Pain Types (Nociceptive and Neuropathic-Like Symptoms) and Frailty in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study

Abstract

Purpose

Chronic pain may accelerate the development of frailty in older adults through a variety of mechanisms. There are no published investigations of the influence of neuropathic-like symptoms on physical frailty. We investigated the association between chronic pain types (nociceptive and neuropathic-like symptoms) and frailty in community-dwelling Japanese older adults.

Participants and Methods

This was a population-based cross-sectional study conducted in 2017 in the city of Itoshima, Japan of 917 participants aged 65–75 years, not in need of long-term care, who had completed the physical function tests and questionnaires administered at measurement sessions held at community centers at three sites over a 1- to 2-month period. Their chronic pain types were classified as no-chronic pain, nociceptive pain, and neuropathic-like symptoms according to their painDETECT scores. Frailty phenotypes were defined by the following five components: unintentional weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. A logistic regression model was used to compute the odds ratios (ORs) and 95% confidence interval (CIs) for frailty status outcomes.

Results

The prevalence of pre-frailty was 51.9%, and that of frailty was 5.1%. In multinomial logistic regression analyses, compared to the no-chronic pain group, the OR for the presence of pre-frailty among the participants with nociceptive pain was 1.54 (95% CI: 1.04–2.30, p=0.03), and the OR for the presence of frailty among the participants with neuropathic-like symptoms was 4.37 (95% CI: 1.10–17.37, p=0.04). The neuropathic sensory symptoms of burning, tingling/prickling, and numbness were each associated with frailty, but not with the risk of pre-frailty.

Conclusion

Neuropathic-like symptoms were significantly associated with the presence of frailty in community-dwelling Japanese older adults. Chronic pain types might have different effects on frailty status.

Keywords:

• nociceptive pain
• neuropathic pain
• nociceptive pain
• chronic pain
• frailty
• community-dwelling

Abbreviations

BMI, body mass index; CHS, Cardiovascular Health Study; CI, confidence interval; MMSE, Mini-Mental State Examination; OR, odds ratio; PD-Q, painDETECT questionnaire; QST, quantitative sensory testing, SD, standard deviation.

Acknowledgments

We thank Dr. Shuzo Kumagai, Dr. Tao Chen, and the Itoshima City Office for their support in designing this study and recruiting participants.

Disclosure

The authors have no conflicts of interest to declare.

Additional information

Funding

This study was supported in part by a grant from the Japan Agency for Medical Research and Development (no. JP17942839); by Grants-in-Aid for Scientific Research (B) (nos. JP 20H04016 and JP20H04030) and (C) (nos. JP20K102692, JP20K11446, and JP20K12510) and Research Activity Start-up (no. JP19K24259) from the Ministry of Education, Culture, Sports, Science and Technology of Japan; by Itoshima City (2021-0032), and by Asanohi Orthopaedic Clinic (2020-0528). None of the funding sources had any role in the study design, data analysis, data interpretation, writing of the manuscript, or decisions concerning the submission of this article.