{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:53:40Z","timestamp":1790610820560,"version":"4.1.0"},"reference-count":56,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Malnutrition may increase the risk of frailty in individuals with musculoskeletal pain. However, this scenario has not been explored in detail. As such, the present study was conducted to examine the effects of malnutrition on the risk of incident and worsening frailty in community-dwelling older adults with musculoskeletal pain. Methods: Data from 895 community-dwelling older adults participating in the Toledo Study of Healthy Ageing who reported experiencing musculoskeletal pain during the month preceding data collection (mean age: 74.9 \u00b1 5.6 years) were analyzed. Pain characteristics (i.e., intensity, locations, and treatment) were assessed based on self-reported information regarding the last month. Malnutrition was operationalized according to the GLIM criteria. Frailty status was assessed at baseline and at follow-up (~2.99 years), according to the Frailty Phenotype paradigm, operationalized through the Frailty Trait Scale 5. Associations between the variables were tested using logistic regression analyses adjusted for many covariates established a priori. Results: Malnutrition increased the risk of frailty (odds ratio [OR] = 4.41) and worsening of frailty status (OR = 6.25) in the participants who used \u22652 groups of painkillers in comparison to their non-undernourished peers. Conclusions: The findings of the present study indicate that malnutrition increases the risk of both developing and worsening frailty in older adults with musculoskeletal disorders. In particular, an increased risk of incident frailty and worsening frailty status was found in undernourished individuals using \u22652 analgesic drugs. Our results suggest that nutritional assessment should be included in the evaluation of old people living with musculoskeletal pain.<\/jats:p>","DOI":"10.3390\/nu17091400","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T20:11:48Z","timestamp":1745352708000},"page":"1400","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Malnutrition on the Incidence and Worsening of Frailty in Community-Dwelling Older Adults with Pain"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7899-9203","authenticated-orcid":false,"given":"Isabel","family":"Rodr\u00edguez-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Geriatrics Department, Hospital Universitario Cl\u00ednico San Carlos, 28905 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Hospital Cl\u00ednico San Carlos, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5537-9201","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"Carnicero-Carre\u00f1o","sequence":"additional","affiliation":[{"name":"Geriatrics Department, Virgen del Valle Hospital, 45007 Toledo, Spain"},{"name":"Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-7204","authenticated-orcid":false,"given":"Alejandro","family":"\u00c1lvarez-Bustos","sequence":"additional","affiliation":[{"name":"Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n IdiPaz, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"Garc\u00eda-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Geriatrics Department, Virgen del Valle Hospital, 45007 Toledo, Spain"},{"name":"Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6551-1333","authenticated-orcid":false,"given":"Leocadio","family":"Rodr\u00edguez-Ma\u00f1as","sequence":"additional","affiliation":[{"name":"Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain"},{"name":"Geriatrics Department, Getafe University Hospital, 28905 Getafe, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7482-9514","authenticated-orcid":false,"given":"H\u00e9lio Jos\u00e9","family":"Coelho-J\u00fanior","sequence":"additional","affiliation":[{"name":"Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, 28029 Madrid, Spain"},{"name":"Geriatrics Department, Getafe University Hospital, 28905 Getafe, Spain"},{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 328 Diseases and Injuries for 195 Countries, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Vos","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, Regional, and National Burden of Low Back Pain, 1990-2020, Its Attributable Risk Factors, and Projections to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021","volume":"5","author":"Ferreira","year":"2023","journal-title":"Lancet Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.15585\/mmwr.mm6736a2","article-title":"Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults\u2014United States, 2016","volume":"67","author":"Dahlhamer","year":"2018","journal-title":"MMWR Morb. 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