Drugs & Aging

, Volume 30, Issue 2, pp 129–136

Analgesic Use and Frailty among Community-Dwelling Older People

A Population-Based Study
  • Marjaana P. H. Koponen
  • J. Simon Bell
  • Niina M. Karttunen
  • Irma A. Nykänen
  • Franciska A. M. Desplenter
  • Sirpa A. Hartikainen
Original Research Article

DOI: 10.1007/s40266-012-0046-8

Cite this article as:
Koponen, M.P.H., Bell, J.S., Karttunen, N.M. et al. Drugs Aging (2013) 30: 129. doi:10.1007/s40266-012-0046-8

Abstract

Background

Frail older people have a decreased ability to respond to stressors and may therefore be more susceptible to adverse events related to inadequately treated pain. Conversely, aging- and frailty-related changes in pharmacokinetics and pharmacodynamics may predispose frail older people to adverse events of analgesics.

Objective

The aim of this study was to explore whether analgesic use is associated with frailty status and whether there are differences in the types of analgesics used between frailty groups among community-dwelling older people.

Methods

The study population consisted of 605 community-dwelling people aged >75 years. Demographic, diagnostic and drug use data were collected during standardized nurse interviews. Participants were classified as frail, pre-frail or robust using the Cardiovascular Health Study frailty criteria (weight loss, weakness, exhaustion, slowness and low physical activity).

Results

Overall, 11.4 % (n = 69) of the study participants were frail and 49.4 % (n = 299) were pre-frail. The prevalence of prescription and non-prescription analgesic use was higher among frail (68.1 %) than among pre-frail (54.5 %) and robust (40.5 %) older people (p < 0.001). In multivariate analyses, frailty was positively associated with analgesic use (odds ratio 2.96; 95 % CI 1.38–6.36). However, frail analgesic users (46.7 %) were more likely to want their physicians to pay greater attention to pain management than robust (23.2 %) analgesic users. The most prevalent analgesic was acetaminophen (paracetamol) among frail (78.7 %) and pre-frail (63.2 %), and NSAIDs among robust (60.4 %) analgesic users. Frail (60.3 %) and pre-frail (58.1 %) participants were more likely to report musculoskeletal pain than robust (44.7 %) participants. Of robust, pre-frail and frail older people 33.0 %, 23.1 % and 4.9 % (respectively) did not use any analgesics to treat their pain.

Conclusions

Frailty was associated with a higher prevalence of analgesic use. As frail older people may be more susceptible to adverse events, careful selection of analgesics is warranted. Clinicians should pay more attention to pain management to ensure adequate pain relief.

Copyright information

© Springer International Publishing Switzerland 2012

Authors and Affiliations

  • Marjaana P. H. Koponen
    • 1
    • 2
  • J. Simon Bell
    • 1
    • 3
    • 4
  • Niina M. Karttunen
    • 1
    • 3
  • Irma A. Nykänen
    • 1
    • 3
  • Franciska A. M. Desplenter
    • 1
    • 3
    • 5
  • Sirpa A. Hartikainen
    • 1
    • 3
  1. 1.Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
  2. 2.Social Pharmacy, School of Pharmacy, Faculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
  3. 3.Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
  4. 4.Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical SciencesUniversity of South AustraliaAdelaideAustralia
  5. 5.Research Centre for Pharmaceutical Care and Pharmacoeconomics, Faculty of Pharmaceutical SciencesKatholieke Universiteit LeuvenLeuvenBelgium

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