Is the experience of chronic pain different in frail older adults? A cross-sectional exploratory study

Chronic pain is highly prevalent in frail older adults, resulting in reduced mobility and poor quality of life. However, research on the experience of chronic pain among frail older adults is scarce. To compare the experience of chronic pain among frail, prefrail, and non-frail older adults, and to identify associations involving pain measures and frailty syndrome. We conducted a cross-sectional study with older adults aged ≥ 60 years presenting chronic pain. The participants were recruited by convenience in specialized outpatient services at public hospitals. Frailty syndrome was identified through the frailty phenotype. The experience of pain was compared among the groups, and we conducted a multivariate logistic regression analysis adjusted for covariates. Out of the 135 participants, 36.3% were non-frail, 38.5%, prefrail, and 25.2%, frail. Frail older adults presented severe pain more frequently (p = 0.009) and had worse scores for neuropathic pain (mean: 4.1; 95%CI: 3.2–5.1) and depression associated with chronic pain (mean: 9.7; 95%CI: 7.9–11.5) compared with non-frail older adults (p < 0.001). Moreover, frail older adults presented worse multidimensional pain scores (mean: 59.4; 95%CI: 51.7–67.2) compared with non-frail (p = 0.001) and prefrail older adults (p = 0.017). Frail older adults were 3.5-fold as likely to present neuropathic pain, and they presented a 7-fold higher risk of severe pain than non-frail and prefrail older adults. Frail older adults present severe chronic pain and experience neuropathic pain more frequently. Comprehensive chronic pain assessment and management in this population is critical to achieve active and healthy aging.