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ORIGINAL RESEARCH article

Front. Med.
Sec. Geriatric Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1396328
This article is part of the Research Topic Pain in the Older Adult Patient View all 4 articles

The Vicious Cycle of Frailty and Pain: A Two-Sided Causal Relationship Revealed

Provisionally accepted
Ruipeng Zhong Ruipeng Zhong 1Yijian Chen Yijian Chen 1*Lanhua Zhong Lanhua Zhong 1*Guiming Huang Guiming Huang 1*Weidong Liang Weidong Liang 2Yun Zou Yun Zou 2*
  • 1 Ganzhou People's Hospital, Ganzhou, China
  • 2 First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China

The final, formatted version of the article will be published soon.

    The decline in physiological functions in the older people is frequently accompanied with pain and frailty, yet the causal connection between frailty and pain remains uncertain. In this study, we utilised a two-sample Mendelian randomisation (MR) approach to investigate the potential causal association between frailty and pain.Method: Two-sample bidirectional MR was conducted using summary data from genome-wide association studies to examine the potential causal relationship between frailty (defined by the frailty index and frailty phenotype) and pain. Summary genomewide association statistics were extracted from populations of European ancestry.We also investigated the causal relationship between frailty and site-specific pain, including joint pain, limb pain, thoracic spine pain and low back pain. Causal effects were estimated using the inverse variance weighting method. Sensitivity analyses were performed to validate the robustness of the results.Results: Genetic predisposition to frailty was associated with an increased risk of pain (frailty phenotype odds ratio [OR]: 1.73; P = 3.54×10 -6 , frailty index OR: 1.36; P = 2.43×10 -4 ). Meanwhile, individuals with a genetic inclination towards pain had a higher risk of developing frailty. Regarding site-specific pain, genetic prediction of the frailty phenotype increased the occurrence risk of joint pain, limb pain and low back pain. Reverse MR analysis further showed that limb pain and low back pain were associated with an increased risk of frailty occurrence.This study presented evidence supporting a bidirectional causal relationship between frailty and pain. We highlighted the significance of addressing pain to prevent frailty and recommend the inclusion of pain assessment in the evaluation system for frailty.

    Keywords: Ageing, Frailty, Pain, Causal effect, Mendelian randomisation

    Received: 05 Mar 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Zhong, Chen, Zhong, Huang, Liang and Zou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yijian Chen, Ganzhou People's Hospital, Ganzhou, China
    Lanhua Zhong, Ganzhou People's Hospital, Ganzhou, China
    Guiming Huang, Ganzhou People's Hospital, Ganzhou, China
    Yun Zou, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.