{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:03:37Z","timestamp":1781625817093,"version":"3.54.5"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100014597","name":"Universidade da Coru\u00f1a","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014597","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aging Clin Exp Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain in older adults is highly prevalent, multifactorial, and often associated with greater intensity, multisite involvement, and functional impairment. Despite its burden, it remains frequently underdiagnosed and undertreated. Chronological age alone does not adequately capture biological vulnerability or interindividual variability in pain expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the associations of frailty, an indirect marker of biological age, and chronological age with chronic pain characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study including 455 adults (\u226518 years) recruited from primary care. Thirty-three pain characteristics were assessed through structured interviews. Frailty was quantified using a 31-item Frailty Index based on the deficit accumulation model. Associations of frailty, chronological age, and sex with each pain variable were analyzed using multivariable linear and logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most pain characteristics were more consistently associated with frailty than with chronological age, although effect sizes were modest (sr\n                      <jats:sup>2<\/jats:sup>\n                      typically 1\u20135%). Frailty correlated with greater pain intensity (sr 0.23, r\n                      <jats:sup>2<\/jats:sup>\n                      5.3%), higher frequency (sr 0.10, r\n                      <jats:sup>2<\/jats:sup>\n                      1.1%), and continuous or mixed-type pain (OR 0.97, 95% CI 0.95\u20130.99). In contrast, chronological age primarily predicted temporal aspects, including pain duration, diagnostic delay, and time to first analgesic prescription. Age and frailty showed opposite directions of association for certain domains, such as accompanying symptoms and daily pain duration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frailty provides complementary information to chronological age in characterizing chronic pain. Integrating frailty assessment into routine pain evaluation may enable more individualized management, enhance pain control, and reduce age-related disparities in clinical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40520-025-03273-4","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T11:26:35Z","timestamp":1764674795000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From age to frailty: redefining chronic pain characterization"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-4175","authenticated-orcid":false,"given":"Pablo","family":"Mourelle-Sanmart\u00edn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lorenzo-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Carlos","family":"Mill\u00e1n-Calenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa Kathryn","family":"Andrew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Theou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"issue":"1","key":"3273_CR1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","volume":"160","author":"RD Treede","year":"2018","unstructured":"Treede RD, Rief W, Barke A et al (2018) Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases (ICD-11). Pain 160(1):19\u201327. https:\/\/doi.org\/10.1097\/j.pain.0000000000001384","journal-title":"Pain"},{"issue":"1","key":"3273_CR2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/bja\/aen090","volume":"101","author":"JF Karp","year":"2008","unstructured":"Karp JF, Shega JW, Morone NE, Weiner DK (2008) Advances in Understanding the mechanisms and management of persistent pain in older adults. Br J Anaesth 101(1):111\u2013120. https:\/\/doi.org\/10.1093\/bja\/aen090","journal-title":"Br J Anaesth"},{"key":"3273_CR3","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.pnpbp.2019.04.006","volume":"93","author":"AF Domenichiello","year":"2019","unstructured":"Domenichiello AF, Ramsden CE (2019) The silent epidemic of chronic pain in older adults. Prog Neuropsychopharmacol Biol Psychiatry 93:284\u2013290. https:\/\/doi.org\/10.1016\/j.pnpbp.2019.04.006","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"8 August","key":"3273_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0236111","volume":"15","author":"R Imai","year":"2020","unstructured":"Imai R, Imaoka M, Nakao H et al (2020) Association between chronic pain and pre-frailty in Japanese community-dwelling older adults: A cross-sectional study. PLoS ONE 15(8 August):1\u201313. https:\/\/doi.org\/10.1371\/journal.pone.0236111","journal-title":"PLoS ONE"},{"issue":"8","key":"3273_CR5","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1007\/s40520-018-1061-3","volume":"31","author":"S Thapa","year":"2019","unstructured":"Thapa S, Shmerling RH, Bean JF, Cai Y, Leveille SG (2019) Chronic multisite pain: evaluation of a new geriatric syndrome. Aging Clin Exp Res 31(8):1129\u20131137. https:\/\/doi.org\/10.1007\/s40520-018-1061-3","journal-title":"Aging Clin Exp Res"},{"issue":"2","key":"3273_CR6","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.jpain.2018.07.006","volume":"20","author":"MH Pitcher","year":"2019","unstructured":"Pitcher MH, Von Korff M, Bushnell MC, Porter L (2019) Prevalence and profile of high-impact chronic pain in the united States. J Pain 20(2):146\u2013160. https:\/\/doi.org\/10.1016\/j.jpain.2018.07.006","journal-title":"J Pain"},{"issue":"3","key":"3273_CR7","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1017\/S0959259815000143","volume":"25","author":"L Brown","year":"2015","unstructured":"Brown L, Young J, Clegg A, Heaven A (2015) Pain in older people with frailty. Rev Clin Gerontol 25(3):159\u2013171. https:\/\/doi.org\/10.1017\/S0959259815000143","journal-title":"Rev Clin Gerontol"},{"key":"3273_CR8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.2147\/CIA.S30165","volume":"8","author":"R Rastogi","year":"2013","unstructured":"Rastogi R, Meek BD (2013) Management of chronic pain in elderly, frail patients: finding a suitable, personalized method of control. Clin Interv Aging 8:37\u201346. https:\/\/doi.org\/10.2147\/CIA.S30165","journal-title":"Clin Interv Aging"},{"issue":"6","key":"3273_CR9","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1111\/jgs.12848","volume":"62","author":"LH Eggermont","year":"2014","unstructured":"Eggermont LH, Leveille SG, Shi L et al (2014) Pain characteristics associated with the onset of disability in older adults: the maintenance of balance, independent living, intellect, and zest in the elderly Boston study. J Am Geriatr Soc 62(6):1007\u20131016. https:\/\/doi.org\/10.1111\/jgs.12848","journal-title":"J Am Geriatr Soc"},{"issue":"10","key":"3273_CR10","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1093\/pm\/pny270","volume":"20","author":"SD Rundell","year":"2019","unstructured":"Rundell SD, Patel KV, Krook MA et al (2019) Multisite pain among older adults with persistent back pain and its association with longitudinal outcomes. Pain Med 20(10):1898\u20131906. https:\/\/doi.org\/10.1093\/pm\/pny270","journal-title":"Pain Med"},{"issue":"5","key":"3273_CR11","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1093\/ageing\/afi146","volume":"34","author":"K Rockwood","year":"2005","unstructured":"Rockwood K (2005) What would make a definition of frailty successful? Age Ageing 34(5):432\u2013434. https:\/\/doi.org\/10.1093\/ageing\/afi146","journal-title":"Age Ageing"},{"issue":"3","key":"3273_CR12","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1093\/gerona\/56.3.m146","volume":"56","author":"LP Fried","year":"2001","unstructured":"Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol Biol Sci Med Sci 56(3):146\u2013157. https:\/\/doi.org\/10.1093\/gerona\/56.3.m146","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"9","key":"3273_CR13","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s12603-019-1273-z","volume":"23","author":"E Dent","year":"2019","unstructured":"Dent E, Morley JE, Cruz-Jentoft AJ et al (2019) Physical frailty: ICFSR international clinical practice guidelines for identification and management. J Nutr Heal Aging 23(9):771\u2013787. https:\/\/doi.org\/10.1007\/s12603-019-1273-z","journal-title":"J Nutr Heal Aging"},{"key":"3273_CR14","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1100\/tsw.2001.58","volume":"1","author":"AB Mitnitski","year":"2001","unstructured":"Mitnitski AB, Mogilner AJ, Rockwood K (2001) Accumulation of deficits as a proxy measure of aging. ScientificWorldJournal 1:323\u2013336. https:\/\/doi.org\/10.1100\/tsw.2001.58","journal-title":"ScientificWorldJournal"},{"key":"3273_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2318-8-24","volume":"8","author":"SD Searle","year":"2008","unstructured":"Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K (2008) A standard procedure for creating a frailty index. BMC Geriatr 8:1\u201310. https:\/\/doi.org\/10.1186\/1471-2318-8-24","journal-title":"BMC Geriatr"},{"issue":"12","key":"3273_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ageing\/afad221","volume":"52","author":"O Theou","year":"2023","unstructured":"Theou O, Haviva C, Wallace L, Searle SD, Rockwood K (2023) How to construct a frailty index from an existing dataset in 10 steps. Age Ageing 52(12):1\u20137. https:\/\/doi.org\/10.1093\/ageing\/afad221","journal-title":"Age Ageing"},{"issue":"7","key":"3273_CR17","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1093\/gerona\/62.7.738","volume":"62","author":"K Rockwood","year":"2007","unstructured":"Rockwood K, Andrew M, Mitnitski A (2007) A comparison of two approaches to measuring frailty in elderly people. J Gerontol Biol Sci Med Sci 62(7):738\u2013743. https:\/\/doi.org\/10.1093\/gerona\/62.7.738","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"2","key":"3273_CR18","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.archger.2012.03.001","volume":"55","author":"O Theou","year":"2012","unstructured":"Theou O, Rockwood MRH, Mitnitski A, Rockwood K (2012) Disability and co-morbidity in relation to frailty: how much do they overlap? Arch Gerontol Geriatr 55(2):e1. https:\/\/doi.org\/10.1016\/j.archger.2012.03.001","journal-title":"Arch Gerontol Geriatr"},{"issue":"6","key":"3273_CR19","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1093\/gerona\/59.6.m627","volume":"59","author":"AB Mitnitski","year":"2004","unstructured":"Mitnitski AB, Song X, Rockwood K (2004) The Estimation of relative fitness and frailty in community-dwelling older adults using self-report data. J Gerontol Biol Sci Med Sci 59(6):627\u2013632. https:\/\/doi.org\/10.1093\/gerona\/59.6.m627","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"10206","key":"3273_CR20","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","volume":"394","author":"EO Hoogendijk","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried L (2019) Frailty: implications for clinical practice and public health. Lancet 394(10206):1365\u20131375. https:\/\/doi.org\/10.1016\/S0140-6736(19)31786-6","journal-title":"Lancet"},{"key":"3273_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2318-2-1","volume":"2","author":"AB Mitnitski","year":"2002","unstructured":"Mitnitski AB, Graham JE, Mogilner AJ, Rockwood K (2002) Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr 2:1\u20138. https:\/\/doi.org\/10.1186\/1471-2318-2-1","journal-title":"BMC Geriatr"},{"key":"3273_CR22","doi-asserted-by":"publisher","unstructured":"Diebel LW, Rockwood K (2021) Determination of biological age: geriatric assessment vs biological biomarkers. Curr Oncol Rep 23(9). https:\/\/doi.org\/10.1007\/s11912-021-01097-9","DOI":"10.1007\/s11912-021-01097-9"},{"key":"3273_CR23","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1159\/000381164","volume":"41","author":"O Theou","year":"2015","unstructured":"Theou O, Walston J, Rockwood K (2015) Operationalizing frailty using the frailty phenotype and deficit accumulaton approaches. Interdiscip Top Gerontol Geriatr 41:66\u201373. https:\/\/doi.org\/10.1159\/000381164","journal-title":"Interdiscip Top Gerontol Geriatr"},{"key":"3273_CR24","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1159\/000381166","volume":"41","author":"O Theou","year":"2015","unstructured":"Theou O, Rockwood K (2015) Comparison and clinical applications of the frailty phenotype and frailty index approaches. Interdiscip Top Gerontol Geriatr 41:74\u201384. https:\/\/doi.org\/10.1159\/000381166","journal-title":"Interdiscip Top Gerontol Geriatr"},{"issue":"6","key":"3273_CR25","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1093\/ageing\/afy104","volume":"47","author":"MD Saraiva","year":"2018","unstructured":"Saraiva MD, Suzuki GS, Lin SM, de Andrade DC, Jacob-Filho W, Suemoto CK (2018) Persistent pain is a risk factor for frailty: A systematic review and meta-analysis from prospective longitudinal studies. Age Ageing 47(6):785\u2013793. https:\/\/doi.org\/10.1093\/ageing\/afy104","journal-title":"Age Ageing"},{"issue":"6","key":"3273_CR26","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1007\/s41999-020-00382-3","volume":"11","author":"T Lin","year":"2020","unstructured":"Lin T, Zhao Y, Xia X, Ge N, Yue J (2020) Association between frailty and chronic pain among older adults: A systematic review and meta-analysis. Eur Geriatr Med 11(6):945\u2013959. https:\/\/doi.org\/10.1007\/s41999-020-00382-3","journal-title":"Eur Geriatr Med"},{"issue":"3","key":"3273_CR27","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1093\/ageing\/afy012","volume":"47","author":"RZ Megale","year":"2018","unstructured":"Megale RZ, Ferreira ML, Ferreira PH et al (2018) Association between pain and the frailty phenotype in older men: longitudinal results from the concord health and ageing in men project (CHAMP). Age Ageing 47(3):381\u2013387. https:\/\/doi.org\/10.1093\/ageing\/afy012","journal-title":"Age Ageing"},{"issue":"2","key":"3273_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2017-018716","volume":"8","author":"JH Chiou","year":"2018","unstructured":"Chiou JH, Liu LK, Lee WJ, Peng LN, Chen LK (2018) What factors mediate the inter-relationship between frailty and pain in cognitively and functionally sound older adults? A prospective longitudinal ageing cohort study in Taiwan. BMJ Open 8(2):1\u20139. https:\/\/doi.org\/10.1136\/bmjopen-2017-018716","journal-title":"BMJ Open"},{"issue":"3","key":"3273_CR29","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1093\/pm\/pnw163","volume":"18","author":"N Veronese","year":"2017","unstructured":"Veronese N, Maggi S, Trevisan C et al (2017) Pain increases the risk of developing frailty in older adults with osteoarthritis. Pain Med 18(3):414\u2013427. https:\/\/doi.org\/10.1093\/pm\/pnw163","journal-title":"Pain Med"},{"issue":"2","key":"3273_CR30","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1093\/gerona\/glw212","volume":"72","author":"MC Lohman","year":"2017","unstructured":"Lohman MC, Whiteman KL, Greenberg RL, Bruce ML (2017) Incorporating persistent pain in phenotypic frailty measurement and prediction of adverse health outcomes. J Gerontol Biol Sci Med Sci 72(2):216\u2013222. https:\/\/doi.org\/10.1093\/gerona\/glw212","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"2","key":"3273_CR31","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1097\/j.pain.0000000000001105","volume":"159","author":"X Tian","year":"2018","unstructured":"Tian X, Wang C, Qiao X et al (2018) Association between pain and frailty among Chinese community-dwelling older adults: depression as a mediator and its interaction with pain. Pain 159(2):306\u2013313. https:\/\/doi.org\/10.1097\/j.pain.0000000000001105","journal-title":"Pain"},{"issue":"4","key":"3273_CR32","doi-asserted-by":"publisher","first-page":"e60700","DOI":"10.1590\/1983-1447.2016.04.60700","volume":"37","author":"D de Morais","year":"2017","unstructured":"de Morais D, Terassi M, Inouye K, Luchesi BM, Pavarini SCI (2017) Chronic pain in elderly caregivers at different levels of frailty. Rev Gauch Enferm 37(4):e60700. https:\/\/doi.org\/10.1590\/1983-1447.2016.04.60700","journal-title":"Rev Gauch Enferm"},{"issue":"5","key":"3273_CR33","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/jpm.12303","volume":"23","author":"MMY Tse","year":"2016","unstructured":"Tse MMY (2016) Frailty, pain and psychological variables among older adults living in Hong Kong nursing homes: can we do better to address multimorbidities? J Psychiatr Ment Health Nurs 23(5):303\u2013311. https:\/\/doi.org\/10.1111\/jpm.12303","journal-title":"J Psychiatr Ment Health Nurs"},{"issue":"4","key":"3273_CR34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.14283\/jfa.2015.75","volume":"4","author":"P Coyle","year":"2015","unstructured":"Coyle P, Sions J, Velasco T, Chicks G (2015) Older adults with chronic low back pain: A clinical population vulnerable to frailty? J Frailty Aging 4(4):1\u20133. https:\/\/doi.org\/10.14283\/jfa.2015.75","journal-title":"J Frailty Aging"},{"issue":"3","key":"3273_CR35","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1093\/gerona\/glu102","volume":"70","author":"D Misra","year":"2015","unstructured":"Misra D, Felson DT, Silliman RA et al (2015) Knee osteoarthritis and frailty: findings from the multicenter osteoarthritis study and osteoarthritis initiative. J Gerontol Biol Sci Med Sci 70(3):339\u2013344. https:\/\/doi.org\/10.1093\/gerona\/glu102","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"5","key":"3273_CR36","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1093\/gerona\/glt126","volume":"69","author":"BL Wise","year":"2014","unstructured":"Wise BL, Parimi N, Zhang Y et al (2014) Frailty and hip osteoarthritis in men in the MrOS cohort. J Gerontol Biol Sci Med Sci 69(5):602\u2013608. https:\/\/doi.org\/10.1093\/gerona\/glt126","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"1","key":"3273_CR37","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/ageing\/afx122","volume":"47","author":"G Livshits","year":"2018","unstructured":"Livshits G, Lochlainn MN, Malkin I et al (2018) Shared genetic influence on frailty and chronic widespread pain: A study from TwinsUK. Age Ageing 47(1):119\u2013125. https:\/\/doi.org\/10.1093\/ageing\/afx122","journal-title":"Age Ageing"},{"issue":"1","key":"3273_CR38","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.archger.2014.02.006","volume":"59","author":"L Hermsen","year":"2014","unstructured":"Hermsen L, Leone S, Smalbrugge M, Dekker J, van der Horst H (2014) Frequency, severity and determinants of functional limitations in older adults with joint pain and comorbidity: results of a cross-sectional study. Arch Gerontol Geriatr 59(1):98\u2013106. https:\/\/doi.org\/10.1016\/j.archger.2014.02.006","journal-title":"Arch Gerontol Geriatr"},{"issue":"2","key":"3273_CR39","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s40266-012-0046-8","volume":"30","author":"M Koponen","year":"2013","unstructured":"Koponen M, Bell S, Karttunen N, Nyk\u00e4nen I, Desplenter F, Hartikainen S (2013) Analgesic use and frailty among community-dwelling older people: A population-based study. Drugs Aging 30(2):129\u2013136. https:\/\/doi.org\/10.1007\/s40266-012-0046-8","journal-title":"Drugs Aging"},{"issue":"6","key":"3273_CR40","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1111\/j.1532-5415.2009.02263.x","volume":"57","author":"GD Weaver","year":"2009","unstructured":"Weaver GD, Kuo YF, Raji MA et al (2009) Pain and disability in Mexican-American older adults. J Am Geriatr Soc 57(6):992\u2013999. https:\/\/doi.org\/10.1111\/j.1532-5415.2009.02263.x","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"3273_CR41","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/j.pmn.2021.04.007","volume":"23","author":"H Ning","year":"2022","unstructured":"Ning H, Zhao Y, Liao L et al (2022) Impact of pain and psychosocial factors on frailty among older adults with physical functional limitations: A cross-sectional study. Pain Manag Nurs 23(3):338\u2013344. https:\/\/doi.org\/10.1016\/j.pmn.2021.04.007","journal-title":"Pain Manag Nurs"},{"issue":"1","key":"3273_CR42","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1111\/ggi.14100","volume":"21","author":"S Tsuji","year":"2021","unstructured":"Tsuji S, Shinmura K, Nagai K et al (2021) Low back pain is closely associated with frailty but not with sarcopenia: Cross-sectional study of rural Japanese community-dwelling older adults. Geriatr Gerontol Int 21(1):54\u201359. https:\/\/doi.org\/10.1111\/ggi.14100","journal-title":"Geriatr Gerontol Int"},{"issue":"6","key":"3273_CR43","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.pmn.2020.05.009","volume":"21","author":"P Otones Reyes","year":"2020","unstructured":"Otones Reyes P, Garc\u00eda Perea E, Rico Bl\u00e1zquez M, Pedraz Marcos A (2020) Prevalence and correlates of frailty in community-dwelling-older adults with chronic pain: A cross-sectional study. Pain Manag Nurs 21(6):530\u2013535. https:\/\/doi.org\/10.1016\/j.pmn.2020.05.009","journal-title":"Pain Manag Nurs"},{"issue":"6","key":"3273_CR44","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1007\/s41999-019-00235-8","volume":"10","author":"B \u0130lhan","year":"2019","unstructured":"\u0130lhan B, Bahat G, Erdo\u011fan T, K\u0131l\u0131\u00e7 C, Karan MA (2019) Chronic pain: prevalent and independently associated with frailty and female gender in geriatric outpatients. Eur Geriatr Med 10(6):931\u2013937. https:\/\/doi.org\/10.1007\/s41999-019-00235-8","journal-title":"Eur Geriatr Med"},{"issue":"7","key":"3273_CR45","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1136\/rapm-2018-100247","volume":"44","author":"GJ Esses","year":"2019","unstructured":"Esses GJ, Liu X, Lin HM, Khelemsky Y, Deiner S (2019) Preoperative frailty and its association with postsurgical pain in an older patient cohort. Reg Anesth Pain Med 44(7):695\u2013699. https:\/\/doi.org\/10.1136\/rapm-2018-100247","journal-title":"Reg Anesth Pain Med"},{"issue":"1","key":"3273_CR46","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3390\/ijerph16081330","volume":"17","author":"Y Nakai","year":"2020","unstructured":"Nakai Y, Makizako H, Kiyama R, Tomioka K, Taniguchi Y, Kubozono T et al (2020) Association between chronic pain and physical frailty in community-dwelling older adults. Int J Environ Res Public Health 17(1):5\u20138. https:\/\/doi.org\/10.3390\/ijerph16081330","journal-title":"Int J Environ Res Public Health"},{"issue":"11","key":"3273_CR47","doi-asserted-by":"publisher","first-page":"2146","DOI":"10.1093\/pm\/pnx296","volume":"19","author":"SM Bindawas","year":"2018","unstructured":"Bindawas SM, Vennu V, Stubbs B (2018) Longitudinal relationship between knee pain status and incident frailty: data from the osteoarthritis initiative. Pain Med 19(11):2146\u20132153. https:\/\/doi.org\/10.1093\/pm\/pnx296","journal-title":"Pain Med"},{"issue":"2","key":"3273_CR48","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1007\/s40122-020-00202-3","volume":"9","author":"I Ardoino","year":"2020","unstructured":"Ardoino I, Franchi C, Nobili A et al (2020) Pain and frailty in hospitalized older adults. Pain Ther 9(2):727\u2013740. https:\/\/doi.org\/10.1007\/s40122-020-00202-3","journal-title":"Pain Ther"},{"issue":"1","key":"3273_CR49","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1093\/ageing\/afy163","volume":"48","author":"I Rodr\u00edguez-S\u00e1nchez","year":"2019","unstructured":"Rodr\u00edguez-S\u00e1nchez I, Garc\u00eda-Esquinas E, Mesas AE, Mart\u00edn-Moreno JM, Rodr\u00edguez-Ma\u00f1as L, Rodr\u00edguez-Artalejo F (2019) Frequency, intensity and localization of pain as risk factors for frailty in older adults. Age Ageing 48(1):74\u201380. https:\/\/doi.org\/10.1093\/ageing\/afy163","journal-title":"Age Ageing"},{"issue":"3","key":"3273_CR50","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1093\/gerona\/glw226","volume":"72","author":"KF Wade","year":"2017","unstructured":"Wade KF, Marshall A, Vanhoutte B, Wu FCW, O\u2019Neill TW, Lee DM (2017) Does pain predict frailty in older men and women? Findings from the english longitudinal study of ageing (ELSA). J Gerontol Biol Sci Med Sci 72(3):403\u2013409. https:\/\/doi.org\/10.1093\/gerona\/glw226","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"2","key":"3273_CR51","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1093\/ageing\/afv170","volume":"45","author":"KF Wade","year":"2016","unstructured":"Wade KF, Lee DM, Mcbeth J et al (2016) Chronic widespread pain is associated with worsening frailty in European men. Age Ageing 45(2):268\u2013274. https:\/\/doi.org\/10.1093\/ageing\/afv170","journal-title":"Age Ageing"},{"issue":"4","key":"3273_CR52","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1111\/pme.12746","volume":"18","author":"T Coelho","year":"2017","unstructured":"Coelho T, Pa\u00fal C, Gobbens RJ, Fernandes L (2017) Multidimensional frailty and pain in community dwelling elderly. Pain Med 18(4):693\u2013701. https:\/\/doi.org\/10.1111\/pme.12746","journal-title":"Pain Med"},{"issue":"12","key":"3273_CR53","doi-asserted-by":"publisher","first-page":"2135","DOI":"10.1111\/jgs.12554","volume":"61","author":"JW Shega","year":"2013","unstructured":"Shega JW, Andrew M, Kotwal A (2013) Relationship between persistent pain and 5-year mortality: A population-based prospective cohort study. J Am Geriatr Soc 61(12):2135\u20132141. https:\/\/doi.org\/10.1111\/jgs.12554","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"3273_CR54","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1111\/j.1532-5415.2011.03769.x","volume":"60","author":"JW Shega","year":"2012","unstructured":"Shega JW, Dale W, Andrew M (2012) Persistent pain and frailty: A case for homeostenosis. J Am Geriatr Soc 60(1):113\u2013117. https:\/\/doi.org\/10.1111\/j.1532-5415.2011.03769.x","journal-title":"J Am Geriatr Soc"},{"issue":"2","key":"3273_CR55","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1111\/j.1526-4637.2011.01309.x","volume":"13","author":"JW Shega","year":"2012","unstructured":"Shega JW, Andrew M, Hemmerich J et al (2012) The relationship of pain and cognitive impairment with social vulnerability-An analysis of the Canadian study of health and aging. Pain Med 13(2):190\u2013197. https:\/\/doi.org\/10.1111\/j.1526-4637.2011.01309.x","journal-title":"Pain Med"},{"issue":"11","key":"3273_CR56","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1111\/ggi.13785","volume":"19","author":"T Hirase","year":"2019","unstructured":"Hirase T, Makizako H, Okubo Y, Lord SR, Inokuchi S, Okita M (2019) Chronic pain is independently associated with social frailty in community-dwelling older adults. Geriatr Gerontol Int 19(11):1153\u20131156. https:\/\/doi.org\/10.1111\/ggi.13785","journal-title":"Geriatr Gerontol Int"},{"issue":"7","key":"3273_CR57","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1111\/ggi.13314","volume":"18","author":"T Hirase","year":"2018","unstructured":"Hirase T, Kataoka H, Nakano J, Inokuchi S, Sakamoto J, Okita M (2018) Impact of frailty on chronic pain, activities of daily living and physical activity in community-dwelling older adults: A cross-sectional study. Geriatr Gerontol Int 18(7):1079\u20131084. https:\/\/doi.org\/10.1111\/ggi.13314","journal-title":"Geriatr Gerontol Int"},{"key":"3273_CR58","doi-asserted-by":"publisher","unstructured":"Cabrero-Garc\u00eda J, Rico-Juan JR, Oliver-Roig A (2022) Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain. Qual Life Res 31(5):1335\u201344. https:\/\/doi.org\/10.1007\/s11136-021-03057-z","DOI":"10.1007\/s11136-021-03057-z"}],"container-title":["Aging Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-025-03273-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40520-025-03273-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-025-03273-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T14:54:05Z","timestamp":1781621645000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40520-025-03273-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3273"],"URL":"https:\/\/doi.org\/10.1007\/s40520-025-03273-4","relation":{},"ISSN":["1720-8319"],"issn-type":[{"value":"1720-8319","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]},"assertion":[{"value":"9 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The project received approval from the Santiago-Lugo Research Ethics Committee and the Spanish Agency for Medicines and Medical Devices (AEMPS)\n                      (LAO-PAR-2018-01)\n                      . Recruitment was conducted under routine clinical practice conditions. Participants received detailed information about the study and provided informed consent. Data were anonymized to ensure confidentiality, and information was collected using a standardized questionnaire.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"No sponsors participated in the design, methods, data analysis, or preparation of this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Sponsor\u00b4s role"}}],"article-number":"25"}}