Older Mexican American adults experiencing pain are at risk of developing frailty

NIH-funded study calls for policy to manage pain-related frailty unique to older Mexican Americans.

Researchers funded by the National Institutes of Health have found that older Mexican Americans who suffer from pain were 1.7 times likelier to become frail, compared to study participants who did not report pain. The study, published in The Journal of Pain by researchers at the University of Texas Medical Branch, Galveston, looked at pain as a predictor of frailty in older Mexican American adults in a follow-up period of 18 years. All participants were non-frail at the start of the study.

Frailty — defined by unintentional weight loss, weakness, exhaustion and slowness — can lead to poor health outcomes. Factors that led to a higher chance of becoming frail were older age, hip fracture, depressive symptoms and difficulty in performing activities of daily living. Participants with higher education levels, females and those with sounder mental state were less prone to developing frailty, according to researchers.

An estimated 100 million people in the United States have some form of pain, making it one of the most prevalent and expensive medical issues in America. In older adults, chronic pain is a risk factor for frailty but there is not enough knowledge of the relationship between pain and frailty in older Hispanic populations in the U.S., which is the nation’s fastest growing segment of older adults. Older Mexican American adults are particularly prone to risk factors associated with pain, such as diabetes, obesity and disability. They also are more likely to have poor access to medical care and have lower levels of health literacy.

“Older Mexican Americans are an underserved population with disparities in healthcare access and delivery and health risks associated to their demographic group,” said NIMHD Director Eliseo J. Pérez-Stable. “This study identifies the need to effectively manage pain in Latino populations by culturally appropriate interventions.”

Study data was sourced from the Hispanic Established Populations for the Epidemiological Study of the Elderly (H-EPESE), an ongoing longitudinal study of 3,050 Mexican Americans aged 65 years and older and residing in five Southwestern states. Data was collected from 1995/96 and 2012/13.

At the start of data collection, participants were asked if they experienced pain in the previous month. Participants categorized as frail were not included in the study. As social and demographic factors, such as age, sex, marital status, literacy, mental health, disability and existing medical conditions may influence frailty, participants were also categorized along these variables.

“The relationship between social determinants, diabetes, physical function, mobility, frailty and pain in older Mexican Americans is complex and poorly understood. Early assessment and better pain management may prevent early onset of frailty in this group,” said Kenneth Ottenbacher, Ph.D., study principal investigator at UTMB - Galveston.

This study was funded by the National Institute on Minority Health and Health Disparities (NIMHD), the National Institute on Aging (NIA) and the National Institute of Child Health and Human Development (NICHD), all a part of the National Institutes of Health.

NIMHD leads scientific research to improve minority health and eliminate health disparities by conducting and supporting research; planning, reviewing, coordinating, and evaluating all minority health and health disparities research at NIH; promoting and supporting the training of a diverse research workforce; translating and disseminating research information; and fostering collaborations and partnerships. For more information about NIMHD, visit www.nimhd.nih.gov.

NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute’s broad scientific program seeks to understand the nature of aging to extend the healthy, active years of life. For more information on research, aging, and health, go to https://www.nia.nih.gov/.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.