Chronic Pain and Frailty in Community-Dwelling Older Adults: A Systematic Review.

OBJECTIVE: Our aim was to examine the relationship between chronic pain and frailty in community-dwelling older adults. DESIGN: A systematic review method following the Joanna Briggs Institute Reviewers' Manual 2015. DATA SOURCES: MEDLINE, Cochrane Library Plus, Science Direct, Scielo, LILACS, and the Joanna Briggs Institute database of systematic reviews and implementation reports were searched using different combinations of the terms "frail," "frailty," and "pain." REVIEW/ANALYSIS METHODS: Original publications of nononcologic chronic pain and frailty status in community-dwelling older adults published in English or Spanish were included. Because of the heterogeneity of the studies, a narrative approach was used to summarize the results. RESULTS: A total of 23 studies were finally selected for the systematic review. Most of them (n = 14) were cross-sectional studies, and there were also longitudinal studies (n = 4), cohort studies (n = 3), and randomized controlled trials (n = 2). Most of the studies found an association between chronic pain and frailty in terms of prevalence; approximately 45% of frail patients had chronic pain, and prevalence can reach 70%. CONCLUSIONS: The studies analyzed suggest that chronic pain has a predictive effect for frailty in older adults compared with those reporting no pain. Higher pain intensity, chronic widespread pain, and higher pain interference were also related to frailty status. No specific interventions for managing chronic pain in frail or prefrail older adults were found.