• Marcos Daniel Saraiva, Gisele Sayuri Suzuki, Sumika Mori Lin, de Andrade Daniel Ciampi DC Department of Neurology, University of São Paulo Medical School, São Paulo, CEP, Brazil., Wilson Jacob-Filho, and Claudia Kimie Suemoto.
• Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, CEP, Brazil.
• Age Ageing. 2018 Nov 1; 47 (6): 785-793.

Backgroundpain is prevalent in frail older adults; however, the association of pain and frailty has not been evaluated yet by a systematic assessment of prospective longitudinal studies.Objectivewe aimed to assess the association of persistent pain as a risk factor for frailty incidence, using data from longitudinal studies in a systematic review and meta-analysis.Methodspublications were identified using a systematic search on PubMed, Embase, Cochrane Library and clinicaltrials.gov databases from inception to October 2017. Since heterogeneity across studies was high, we used random-effects meta-analysis to calculate the pooled relative risk for the association between persistent pain and the incidence of frailty. We investigated sources of heterogeneity among studies using meta-regression and stratified analyses.Resultswe included five prospective longitudinal studies with 13,120 participants (46% women, mean age from 59 to 85 years old). Participants with persistent pain at baseline had twice the risk of developing frailty during the follow-up (pooled RR = 2.22, 95% CI = 1.14-4.29). No variables were related to study heterogeneity in sensitivity analyses.Conclusionpersistent pain was a risk factor for the development of frailty in a meta-analysis of longitudinal studies. Better understanding of the association between pain and frailty with proper evaluation of potential confounders could allow the development of targeted interventions.

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