Frailty and Chronic Pain Profiles in Patients Aged ≥65 Years

This study is an observational, cross-sectional investigation to be conducted in individuals aged 65 years and older who present to the algology outpatient clinic with complaints of chronic pain. Participation in the study will be entirely voluntary, and written informed consent will be obtained from all participants. Data collection will be carried out through face-to-face interviews with patients and retrospective review of patient medical records.

Frailty status of the participants will be assessed using the FRAIL Scale, which is widely used in the literature and has proven validity. Alternatively, the Fried Frailty Criteria may be used according to the researcher's preference. Based on these assessments, frailty status will be classified into three categories: robust, prefrail, and frail.

The Geriatric Nutritional Risk Index (GNRI), an objective indicator of nutritional status, will be calculated using participants' serum albumin levels, current body weight, and height according to the following formula:

GNRI = (1.489 × serum albumin \[g/L\]) + (41.7 × current body weight / ideal body weight).

This score will be analyzed in relation to frailty status to evaluate nutritional risk.

As part of pain assessment, pain intensity will be measured using the Visual Analog Scale (VAS). To determine pain type, the DN4 (Douleur Neuropathique 4) questionnaire and the painDETECT questionnaire, both of which have established validity for neuropathic pain assessment, will be administered. In addition, pain localization will be classified using a pain localization map, and multisite pain involvement will also be recorded.

All collected data will be recorded in encrypted data forms and stored digitally with access restricted to the research team only. Personal identifying information will not be used at any stage of the study, and full compliance with the principles of confidentiality and privacy will be ensured.This study is an observational, cross-sectional investigation to be conducted in individuals aged 65 years and older who present to the algology outpatient clinic with complaints of chronic pain. Participation in the study will be entirely voluntary, and written informed consent will be obtained from all participants. Data collection will be carried out through face-to-face interviews with patients and retrospective review of patient medical records.

Frailty status of the participants will be assessed using the FRAIL Scale, which is widely used in the literature and has proven validity. Alternatively, the Fried Frailty Criteria may be used according to the researcher's preference. Based on these assessments, frailty status will be classified into three categories: robust, prefrail, and frail.

The Geriatric Nutritional Risk Index (GNRI), an objective indicator of nutritional status, will be calculated using participants' serum albumin levels, current body weight, and height according to the following formula:

GNRI = (1.489 × serum albumin \[g/L\]) + (41.7 × current body weight / ideal body weight).

This score will be analyzed in relation to frailty status to evaluate nutritional risk.

As part of pain assessment, pain intensity will be measured using the Visual Analog Scale (VAS). To determine pain type, the DN4 (Douleur Neuropathique 4) questionnaire and the painDETECT questionnaire, both of which have established validity for neuropathic pain assessment, will be administered. In addition, pain localization will be classified using a pain localization map, and multisite pain involvement will also be recorded.

All collected data will be recorded in encrypted data forms and stored digitally with access restricted to the research team only. Personal identifying information will not be used at any stage of the study, and full compliance with the principles of confidentiality and privacy will be ensured.

Primary outcomes

• primary outcome [baseline]: Frailty status determined according to the Fried Frailty Criteria (Frailty Phenotype). Frailty will be classified as robust (0 criteria), pre-frail (1-2 criteria), or frail (≥3 criteria) based on the presence of unintentional weight loss, exhaustion, low physical activity, slowness, and weakness.

Secondary outcomes

• Secondary outcome [baseline]: Pain intensity was assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where higher scores indicate greater pain severity.
• Secondary Outcome Measure [baseline]: Pain type classification (neuropathic, nociceptive, or mixed), assessed at baseline
• Secondary outcome meaaure [Baseline]: Number of regularly used medications (polypharmacy status).
• Secondary outcome [Baseline]: Pain duration -months
• Secondary outcome [During the 3-month follow-up period.]: Type of pain treatment administered. Categorized as pharmacological, interventional, or combined therapy.
• Secondary outcome [3 months.]: Treatment response. Defined as clinically meaningful pain reduction (≥50% decrease in VAS score compared to baseline).

Sex: All, ages: 65 Years to any

Inclusion Criteria:

Age 65 years or older Diagnosis of chronic pain (duration > 3 months)

Exclusion Criteria:

Acute pain complaint Pain related to malignancy Severe communication impairment

• Results publication: Saito T, Liu X, Yatsugi H, Chu T, Yokote T, Kishimoto H. Relationship Between Chronic Pain Types (Nociceptive and Neuropathic-Like Symptoms) and Frailty in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study. J Pain Res. 2023 Aug 1;16:2675-2684. doi: 10.2147/JPR.S402002. eCollection 2023. PMID 37545692