Associations between symptoms of pain, insomnia and depression, and frailty in older adults: A cross-sectional analysis of a cohort study.
Minhui Liu, Tianxue Hou, Manka Nkimbeng and 5 others
PMID 33621722WHAT IT FOUND
In 7609 community-dwelling older adults, bothersome pain, trouble falling asleep and depressive symptoms were each linked with being pre-frail or frail.
The link was strongest when depressive symptoms occurred with pain or trouble falling asleep.
Key findings
01After adjusting for covariates and other symptoms, bothersome pain, difficulty initiating sleep and depressive symptoms remained associated with being pre-frail or frail, while difficulty maintaining sleep did not.
02Depressive symptoms combined with pain, or with difficulty initiating sleep, were associated with a greater reported likelihood of being pre-frail or frail than each symptom alone.
03In the sample, 53% had bothersome pain, 27% had sleep problems, 15% had depressive symptoms, 46% were pre-frail and 14% were frail.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured symptoms and frailty at one time, so it cannot show that pain, sleep problems or depressive symptoms caused frailty. Pain was measured with a single item about bothersome pain, so the study cannot tell how severe, how strong or how long the pain lasted. Depressive symptoms were screened with PHQ-2, which indicates possible depression but does not measure depression severity. Sleep problems were estimated from two self-report items, not a formal diagnosis of insomnia disorder. The analysis could not include factors such as polypharmacy use and sedentary lifestyle because they were not collected in the dataset. Results apply to community-dwelling older adults and may not apply to older people in residential or clinical settings. For some symptom combinations, confidence intervals were wide, likely because the number of participants in those categories was small.
Declared interests
The authors declared no competing interests. No funder is named in the supplied text.
The easy way to misread this
Do not read the reported odds ratio of 10.20 for pain, trouble falling asleep and depressive symptoms as proof that these symptoms cause frailty. The study measured symptoms and frailty at one time, so it cannot show cause or effect. It also does not show that treating these symptoms will reduce frailty.