Analgesic Use and Frailty among Community-Dwelling Older People

Koponen, Marjaana; Bell, John; Karttunen, Niina; Nykänen, Irma; Desplenter, Franciska; Hartikainen, Sirpa

doi:10.1007/s40266-012-0046-8

Cited by 42 publications

(39 citation statements)

References 33 publications

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“…We identified seven studies which reported pain outcomes in older people with frailty (table 1). One study was conducted in Canada 11,17 , one in Australia 18,19 , one in Finland 20 , two in Taiwan 13,21 , and two in Brazil 22,23 . The mean age of participants ranged from 71 years to 82 years (see table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Chang et al 21 reported the presence of pain history but did not report the specific measure. The Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) study investigated the presence and severity of musculoskeletal pain, and chronicity 20 . The frailty in the Brazilian elderly (FIBRA) study 22 used the Western Ontario and McMaster Universities Questionnaire (WOMAC).…”

Section: Resultsmentioning

confidence: 99%

“…The remaining studies recruited older people without specific conditions. Three studies reported pain intensity 13,20,23 .…”

Section: Resultsmentioning

confidence: 99%

“…In the FIBRA study 22 , mean and median pain scores were non-significantly higher in the frail group. In the GeMS study 20 , over 60% of frail participants had musculoskeletal pain compared to approximately 45% of non-frail participants. Furthermore, significantly more frail and pre-frail participants rated their pain as moderate/severe compared to non-frail.…”

Section: Pain Outcomesmentioning

confidence: 99%

“…In the CHAMP study 19 it was reported that opioid use varied by frailty status with 6.5% of frail men using opioids compared with 2.4% of pre-frail, and 1.2% of not frail men. In the GEMS study 20 , there was a significant increase in analgesic use for increasingly levels of frailty, and use of opioids and acetaminophen (paracetamol)was significantly more prevalent in pre-frail and frail participants compared to non-frail participants. There was no significant difference in the prevalence of use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) between the different frailty states.…”

Section: Analgesic Consumption and Frailtymentioning

confidence: 99%

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Pain in older people with frailty

Brown

Young

Clegg

et al. 2015

Rev. Clin. Gerontol.

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In this review we identified cohort and cross-sectional studies which assessed pain in community-dwelling older people (> 65 years) reliably characterised as frail. Secondly, we considered biologically plausible mechanisms which may alter pain perception, or contribute to, or exacerbate pain in an older person with frailty. Thirdly, we considered specific implications of pain management for this group of people. From the limited data from the seven included studies, it would appear that the presence of pain is higher in older people with frailty compared to people characterised as pre-frail or not frail. Thus, older people reporting pain are more likely to be frail. However, a lack of prospective data precludes inferences about the direction of the relationship: that is whether pain or frailty is the antecedent. Further research is needed to understand the direction of the relationship, and to identify appropriate pain management strategies for older people with frailty.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The remaining studies recruited older people without specific conditions. Three studies reported pain intensity 13,20,23 .…”

Section: Resultsmentioning

confidence: 99%

Section: Pain Outcomesmentioning

confidence: 99%

Section: Analgesic Consumption and Frailtymentioning

confidence: 99%

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Pain in older people with frailty

Brown

Young

Clegg

et al. 2015

Rev. Clin. Gerontol.

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The association between frailty and medicines use over time: an analysis using the Australian Longitudinal Study on Ageing population

Widagdo

Pratt

Roughead

2018

Pharmacy Practice and Res

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Background: Frailty and medicine-related problems are common among the elderly and have been associated with an increased risk of adverse outcomes. However, there has been limited research on the association between frailty and medicines use. Aim: To determine the distribution of frailty among older people who used medicines and to examine the difference in frailty scores over time with continuation or discontinuation of specific medicines. Methods: The study population was from the Australian Longitudinal Study of Ageing (ALSA). The data used in the analysis were collected in 1992 (wave 1) and in 1995 (wave 3). Frailty scores were assessed at both waves using a modified version of the Frailty Index. Non-parametric tests were used to examine the difference in the distribution of frailty scores in relation to medicines used at baseline. Medicine use was categorised into continued or stopped by comparing use at wave 3 to use at baseline. A t-test was used to compare the mean changes in frailty scores between the two groups, with a p-value of <0.05 considered to be significant. Results: Data from 2087 participants were included. At baseline, a higher number of medicines used was associated with higher frailty scores (p < 0.0001). Stopping any preventive medicines, as well as beta-blockers, or potassium-sparing diuretics, was associated with a higher increase in mean frailty score changes than continuing these medicines, p = 0.01, p = 0.03 and p = 0.004, respectively. Conclusions: There was an association between frailty and medicines use. Further study is needed to assess whether the progression of frailty was due to medicine cessation or vice versa.Analysis of frailty and medicines use over time Number of conditions, median (IQR) 5 (3-7) SD = standard deviation; IQR = interquartile range.

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