Frailty and Senior Pain Med Use

Analgesic use higher among frail seniors than peers living in community dwellings

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) With age comes the break down of bodily systems, which can make many seniors frail. Unfortunately, frailty often leads to pain and the need for medicine to manage the pain.

A recent study examined the link between use of pain medication and frailty in senior communities.

Frailty was associated with higher use of pain medication. Only 5 percent of frail seniors did not use pain medication.

"Discuss a pain management plan with your doctor."

Marjaana Koponen, MSc (Pharm), of the University of Eastern Finland, and colleagues studied 605 people over the age of 75 in community dwellings. The patient data was taken from an existing database called the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS).

All patients were interviewed by nurses to determine health status, pain levels, use of medication and socio-demographic factors like gender and income.

Shrinking, weakness, poor endurance and energy, slowness and low physical activity level were used as indicators of frailty. These are widely accepted factors used to determine frailty.

If three or more of the frailty indicators were met, the study participant was considered frail. Those who had one or two of the characteristics were considered pre-frail and those having zero indicators were considered robust.

Mental function was assessed by the Mini-Mental State Examination. Other current health conditions and nutritional status were also evaluated.

Of the study population, about 11 percent were considered frail and almost half were pre-frail.

Use of pain medication was highest among the frail, followed by the pre-frail and then the robust. Frail and pre-frail seniors were more likely to use acetaminophen, like Tylenol, and robust seniors were more likely to use nonsteroidal anti-inflammatory drugs like aspirin.

Among those who used pain medication, the frail users wanted their doctors to pay more attention to pain management than those who were considered robust. Sixty percent of frail, 58 percent of pre-frail and 45 percent of robust reported musculoskeletal pain.

Thirty-three percent of robust, 23 percent of pre-frail and 5 percent of frail seniors did not use any medication to treat their pain.

Whether pain contributes to frailty, frailty contributes to pain or they both contribute to one another is not yet fully understood. 

The authors warned that pain medication for frail seniors should be carefully selected as frail seniors are more susceptible to negative changes in health and side effects.

GeMS was funded by grants from the Social Insurance Institution of Finland and City of Kuopio.

The study was published in Drugs and Aging. The authors reported no conflicts of interest.

Reviewed by: 
Review Date: 
February 20, 2013
Last Updated:
February 22, 2013