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Chen J, Wang X, Xu Z. Sarcopenia and Chronic Pain in the Elderly: A Systematic Review and Meta-Analysis. J Pain Res 2023; 16:3569-3581. [PMID: 37908777 PMCID: PMC10614663 DOI: 10.2147/jpr.s435866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Objective Sarcopenia and chronic pain are prevalent among older adults, and despite numerous studies, the potential epidemiological link between the two conditions remains a topic of controversy. Therefore, we performed a comprehensive systematic review and meta-analysis to assess the relationship between chronic pain and sarcopenia in the elderly. Methods EMBASE, Web of Science, PubMed, and the Cochrane Library were searched through 22 March 2023 with additional manual searches of reference lists of included studies and relevant reviews. We used a random effects model to conduct the meta-analysis and evaluated heterogeneity across studies with Cochran's Q statistic and I2. Subgroup analyses were conducted based on income level, diagnostic criteria for sarcopenia, and pain site. Results 17 observational studies (33,600 participants, 49% female) were included, of which 6 articles were retrieved for narrative review. The pooled prevalence of sarcopenia and the pooled odds ratios (OR) between chronic pain and sarcopenia were extracted from the remaining 11 studies. The pooled prevalence of sarcopenia among older adults suffering from chronic pain was 0.11 (95% CI, 0.08-0.18). Our analysis revealed a statistically significant positive association between chronic pain and an increased risk of sarcopenia, yielding a pooled OR of 1.52 (95% CI, 1.31-1.76). Furthermore, our subgroup analysis demonstrated that the low-income countries group showed a stronger association (OR, 1.73; 95% CI, 1.54-1.95) between chronic pain and sarcopenia than the high-income countries group (OR, 1.38; 95% CI, 1.20-1.60). Conclusion Older adults with chronic pain have a significantly higher prevalence of sarcopenia and risk of developing sarcopenia compared to those without pain. These findings highlight the importance of prioritizing the assessment and early detection of chronic pain in older people, as well as implementing proactive intervention measures in clinical practice. In addition, our results suggest that older people with chronic pain should be actively screened for sarcopenia. Prospero Registration Number CRD42021239807.
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Affiliation(s)
- Jintao Chen
- The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
| | - Xinyi Wang
- The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
| | - Zherong Xu
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People’s Republic of China
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Sahin UK, Şentürk AY. The Relationship between Chronic Musculoskeletal Pain and Sarcopenia Risk in Community-Dwelling Older Adults: A Cross-Sectional Study. Ann Geriatr Med Res 2023; 27:250-257. [PMID: 37635673 PMCID: PMC10556709 DOI: 10.4235/agmr.23.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/19/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND This study aimed to better understand the relationship between chronic musculoskeletal pain and the risk of sarcopenia in older adults. METHODS The risk of sarcopenia was assessed in 210 older adults using the SARC-F (strength, assistance with walking, rising from a chair, ascending stairs, and falls) questionnaire. Geriatric pain measures were used to assess pain. We also recorded the pain sites (ankles/feet, wrists/hands, upper back, lower back, neck, shoulder, hips, and knees). RESULTS Participant mean age was 72.4±7 years, and 109 (51.9%) of the participants were female. The prevalence rates of sarcopenia and chronic musculoskeletal pain were 60% and 92.9%, respectively. Older adults at risk of sarcopenia had a higher mean age, body mass index (BMI), number of comorbidities and falls, presence of chronic pain, pain intensity, and pain sites. Sarcopenia risk was correlated with chronic pain intensity (current and last 7 days) (r=0.506, p<0.001 and r=0.584, p< 0.001, respectively), multisite pain (r=0.442, p< 0.001), and Geriatric Pain Measure score (r=0.730; p< 0.001). Age (odds ratio [OR]=1.1; 95% confidence interval [CI], 1.0-1.2), BMI (OR=1.1; 95% CI, 1.0-1.2), and geriatric pain (OR=1.1; 95% Cl, 1.0-1.1) were associated with sarcopenia risk. CONCLUSIONS The risk of sarcopenia is linked to chronic pain, which frequently occurs in geriatric populations. Our study results also showed that higher pain intensity was associated with a higher risk of sarcopenia. Older adults at risk for sarcopenia often experience chronic musculoskeletal pain, which must be better recognized. Moreover, its significance must be noted in the treatment process.
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Affiliation(s)
- Ulku Kezban Sahin
- Therapy and Rehabilitation, Vocational School of Health Services, Giresun University, Giresun, Turkey
| | - Aysun Yağci Şentürk
- Health Care Services, Tonya Vocational School of Higher Education, Trabzon University, Trabzon, Turkey
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Lin T, Huang X, Guo D, Zhao Y, Song Q, Liang R, Jiang T, Tu X, Deng C, Yue J. Pain as a risk factor for incident sarcopenia in community-dwelling older adults: A 1-year prospective cohort study. J Am Geriatr Soc 2023; 71:546-552. [PMID: 36330882 DOI: 10.1111/jgs.18118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/12/2022] [Accepted: 09/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pain-related muscle disuse and inflammatory reactions may increase the risk of sarcopenia among older adults with pain. Although several studies have examined the association between pain and sarcopenia, the findings are mixed. In the present study, we examined the association of pain as well as pain intensity and location with incident sarcopenia among community-dwelling older adults and explored whether this association differed between men and women. METHODS Pain characteristics, including the presence of pain, intensity (mild, moderate, and severe), and location (multisite, low back, joint, and chest), were self-reported at baseline. Sarcopenia was identified according to the consensus of the Asin Working Group for Sarcopenia 2019 at baseline and 1 year later. Multivariable Poisson regression was used to determine the association of pain status, intensity, and location with incident sarcopenia, respectively. RESULTS Eight hundred seventy-three participants (67.1 ± 4.9 years, 524 female) who were free of sarcopenia at baseline were included, of which 64 (7.3%) developed sarcopenia in the follow-up. The presence of pain was significantly associated with an increased risk of incident sarcopenia in older adults (adjusted RR = 1.83, 95% CI = 1.16-2.89), with a significant risk accumulation in incident sarcopenia upon higher pain intensity. Older adults with multisite pain, low back pain, or joint pain were more likely to develop sarcopenia. Although older men reported a lower prevalence and intensity of pain, their risk of sarcopenia during follow-up was generally more pronounced than older women. CONCLUSIONS Older adults with pain had a significantly higher risk of incident sarcopenia, with a significant risk accumulation in sarcopenia development upon higher pain intensity and specific pain location. Additional attention is needed to identify older adults with pain and to implement timely pain interventions to prevent sarcopenia. High-quality randomized controlled trials are warranted to verify the clinical significance of the present study.
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Affiliation(s)
- Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaotao Huang
- Department of Gastroenterology, Jiangyou 903 Hospital, Mianyang, Sichuan, China
| | - Duan Guo
- Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Rui Liang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Tingting Jiang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiangping Tu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Chuanyao Deng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Zhu X, Zhang X, Ding L, Tang Y, Xu A, Yang F, Qiao G, Gao X, Zhou J. Associations of Pain and Sarcopenia with Successful Aging among Older People in China: Evidence from CHARLS. J Nutr Health Aging 2023; 27:196-201. [PMID: 36973927 DOI: 10.1007/s12603-023-1892-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Sarcopenia and chronic pain are geriatric syndromes that negatively impact the lives of older people. The aim of this study was to explore the relationship among sarcopenia, pain, and successful aging among older persons participating in the China Health and Retirement Longitudinal Study (CHARLS). DESIGN Cohort study with a 2-year follow-up. SETTING AND PARTICIPANTS Data were derived from 2 waves of the CHARLS, and 4280 community-dwelling participants aged ≥ 60 years were included in the study. METHODS Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Successful aging was defined following Rowe and Kahn's multidimensional model. Pain was assessed by a self-reported questionnaire. A generalized estimating equation (GEE) was used to examine the associations. RESULTS Longitudinal results demonstrated that compared with no sarcopenia, possible sarcopenia [OR (95%CI): 0.600 (0.304~1.188)] was not significantly associated with successful aging. Pain only was strongly associated with successful aging [0.388 (0.251~0.600)], whereas the association between sarcopenia only and successful aging was weaker [0.509 (0.287~0.905)]. The likelihood of being successful aging was substantially lower in the presence of coexisting sarcopenia and pain [0.268 (0.108~0.759)]. CONCLUSIONS Both pain and sarcopenia are significant predictors for achieving successful aging among community-dwelling older adults. Early identification of sarcopenia and pain permits the implementation of treatment strategies and presents an opportunity to mitigate the risk of being unsuccessful aging.
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Affiliation(s)
- X Zhu
- Xinhong Zhu, Nursing Educator, School of Nursing, Hubei University of Chinese Medicine, Wuhan, China, phone: +86027-688890395;
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Efendioğlu EM, Çiğiloğlu A, Öztürk ZA. A simple method for clinical implications of pain; comprehensive geriatric assessment. Rev Assoc Med Bras (1992) 2022; 68:1324-1329. [PMID: 36228266 PMCID: PMC9575020 DOI: 10.1590/1806-9282.20220701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/01/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE: The effect of chronic pain on the elderly population is enormous in terms of both human suffering and cost. This study aimed to investigate the factors associated with chronic low back pain in older adults by performing a comprehensive geriatric assessment. METHODS: This cross-sectional study included 225 elderly patients admitted to a geriatric outpatient clinic. All participants underwent a comprehensive geriatric assessment, and factors related to chronic low back pain were assessed. Participants were grouped as those with and without chronic pain. RESULTS: The mean age of the participants was 72.9±6.9 years, and 149 (66.2%) of them had chronic pain complaints. The number of chronic diseases and medications, depressive symptom scores, and sleep quality scores were higher, and quality of life (European Quality of Life-5 Dimensions index and European Quality of Life-5 Dimensions visual analog scale) and nutritional status scores were lower in the chronic pain group. The pain visual analog scale score had a statistically significant moderate negative correlation with the European Quality of Life-5 Dimensions index (r=-0.440, p=0.000) and European Quality of Life-5 Dimensions visual analog scale (r=-0.398, p=0.000) scores. The male gender was associated with a reduced risk of chronic pain, while poor sleep quality and number of comorbidities were associated with an increased risk of chronic pain (p=0.000, OR 0.20, p=0.021, OR 2.54, and p=0.010, OR 1.40, respectively). CONCLUSION: Chronic pain is common and independently associated with poor sleep quality, an increased number of diseases, and female gender. The results of our study may guide pain management in older individuals.
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Affiliation(s)
- Eyyüp Murat Efendioğlu
- Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine – Gaziantep, Turkey.,Corresponding author:
| | - Ahmet Çiğiloğlu
- Kahramanmaraş Necip Fazıl City Hospital, Division of Geriatric Medicine – Kahmaranmaraş, Turkey
| | - Zeynel Abidin Öztürk
- Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine – Gaziantep, Turkey
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Lin T, Dai M, Xu P, Sun L, Shu X, Xia X, Zhao Y, Song Q, Guo D, Deng C, Yue J. Prevalence of Sarcopenia in Pain Patients and Correlation Between the 2 Conditions: A Systematic Review and Meta-analysis. J Am Med Dir Assoc 2022; 23:902.e1-902.e20. [PMID: 35339458 DOI: 10.1016/j.jamda.2022.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Sarcopenia is a generalized and progressive skeletal muscle disorder and has been proven to be associated with many diseases; however, the correlation between sarcopenia and pain has not yet been systematically clarified. This review aimed to investigate the prevalence of sarcopenia in patients with pain and to ascertain whether pain is independently associated with sarcopenia. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS A systematic literature search was performed from the Cochrane Central Register of Controlled Trials, Embase, MEDLINE and Epub Ahead of Print, In-Process, In-Data-Review, and Other Non-Indexed Citations, Daily and Versions for observational studies from inception until February 2021, and our search was updated on December 31, 2021. METHODS Sarcopenia prevalence was calculated according to the corresponding number of patients with sarcopenia and pain. We performed meta-analyses with random effects models to calculate the pooled prevalence of sarcopenia in pain and its correlations. Subgroup analyses were also performed based on pain classification, pain location, and diagnostic criteria for sarcopenia. Heterogeneity between the studies was described using the I2 statistic. RESULTS Fourteen observational studies (13,953 participants, 44% women, and mean age from 40.1 to 76.6 years) were included. Study quality was rated moderate to high. The overall sarcopenia prevalence in patients with pain was 0.11 (95% CI 0.07-0.15, P < .001; I2 = 92.3%). People with pain were independently associated with a higher risk of sarcopenia than those without pain (odds ratio [OR] 1.35; 95% CI 1.17-1.56; P = .025; I2 = 51.1%). Subgroup analyses showed that the cumulative prevalence and effect measures of sarcopenia were increased when individuals suffered secondary musculoskeletal pain (Prevalence = 12%; OR 1.45; 95% CI 1.19-1.78) and low back pain (Prevalence = 21%; OR 1.95; 95% CI 1.22-3.12). CONCLUSIONS AND IMPLICATIONS The prevalence of sarcopenia in patients with pain is relatively high, and pain is significantly associated with sarcopenia in older adults. Attention is needed to screen sarcopenia among patients with pain and optimize its early detection and management in clinical practice.
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Affiliation(s)
- Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Miao Dai
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ping Xu
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan, China
| | - Luwei Sun
- Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan, China
| | - Xiaoyu Shu
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xin Xia
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yanli Zhao
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Duan Guo
- Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Chuanyao Deng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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