Association between frailty and multisite chronic pain in middle-aged and older adults: A population-based cross-sectional study with mediation analysis.
- 1Department of Gastroenterology, Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
- 2Department of Functional Medicine, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
Abstract
The corrected modified frailty index (CMFI), based on the accumulation of multidimensional health impairments, provides a more comprehensive reflection of an individual's overall frailty. Although chronic pain is associated with aging, its relationship with CMFI, in population-based cohorts remains unclear. This cross-sectional study included 5821 participants aged ≥45 years from the 2011 baseline wave of the China Health and Retirement Longitudinal Study. Chronic pain, including low back pain, multisite pain, and the number of pain sites, was assessed via self-reported questionnaires. Frailty was assessed using the CMFI. Weighted logistic regression models, restricted cubic splines, and mediation analyses were employed to investigate associations and the potential roles of depression and C-reactive protein. Analysing data from 5281 participants, higher CMFI was strongly associated with increased risk and burden of chronic pain. Compared with the lowest quartile, the highest CMFI quartile showed significantly higher risks of low back pain (odds ratio = 11.6, 95% confidence interval [CI]: 8.96-15.0), multisite pain (odds ratio = 17.0, 95% CI: 13.1-22.2), and a greater number of pain sites (incidence rate ratio = 11.5, 95% CI: 8.90-14.8). Associations varied across subgroups defined by age, education, and residence. Depression mediated approximately 30% of these associations. Higher CMFI levels were associated with greater risk and burden of chronic pain, with depression potentially accounting for part of the association. These findings highlight the importance of incorporating mental health assessments into frailty and pain management among the middle-aged and older adults included in China Health and Retirement Longitudinal Study.
Related
- Association between frailty and cognitive function in hospitalized older adults: a moderated serial mediation analysis involving functional status, depression, and social support
- Association of chronic pain and BMI with frailty among individuals aged 60 years and older in Beijing: a cross-sectional study
- Association between physical activity and quality of life among breast cancer survivors in China: a cross-sectional mediation analysis
- Association between preferred and documented mode of birth and birth experiences in low- and middle-income countries: a multisite cross-sectional study
- Association of dietary diversity with frailty and pre-frailty in a general Japanese population: the Hisayama Study
BibTeX
@article{cheng2026association,
title = {{Association between frailty and multisite chronic pain in middle-aged and older adults: A population-based cross-sectional study with mediation analysis.}},
author = {Yating Cheng and Yang Ji and Yuning Bai},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051255},
url = {https://europepmc.org/article/MED/42888628},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Association between frailty and multisite chronic pain in middle-aged and older adults: A population-based cross-sectional study with mediation analysis.
AU - Yating Cheng
AU - Yang Ji
AU - Yuning Bai
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051255
UR - https://europepmc.org/article/MED/42888628
AB - The corrected modified frailty index (CMFI), based on the accumulation of multidimensional health impairments, provides a more comprehensive reflection of an individual's overall frailty. Although chronic pain is associated with aging, its relationship with CMFI, in population-based cohorts remains unclear. This cross-sectional study included 5821 participants aged ≥45 years from the 2011 baseline wave of the China Health and Retirement Longitudinal Study. Chronic pain, including low back pain, multisite pain, and the number of pain sites, was assessed via self-reported questionnaires. Frailty was assessed using the CMFI. Weighted logistic regression models, restricted cubic splines, and mediation analyses were employed to investigate associations and the potential roles of depression and C-reactive protein. Analysing data from 5281 participants, higher CMFI was strongly associated with increased risk and burden of chronic pain. Compared with the lowest quartile, the highest CMFI quartile showed significantly higher risks of low back pain (odds ratio = 11.6, 95% confidence interval [CI]: 8.96-15.0), multisite pain (odds ratio = 17.0, 95% CI: 13.1-22.2), and a greater number of pain sites (incidence rate ratio = 11.5, 95% CI: 8.90-14.8). Associations varied across subgroups defined by age, education, and residence. Depression mediated approximately 30% of these associations. Higher CMFI levels were associated with greater risk and burden of chronic pain, with depression potentially accounting for part of the association. These findings highlight the importance of incorporating mental health assessments into frailty and pain management among the middle-aged and older adults included in China Health and Retirement Longitudinal Study.
SN - 0304-5412
SN - 1536-5964
ER -