The Association Between Pain and Physical Frailty Among Older Adults in India: Depression and Insomnia as Mediators.

OBJECTIVES

To investigate the association between body pain and physical frailty among older adults in India and to examine whether this association is mediated by symptoms of depression and insomnia.

METHODS

Data were obtained from the Longitudinal Aging Study in India, comprising 31,464 adults aged 60 and older. Physical frailty was assessed using a modified version of the frailty phenotype developed by Fried and colleagues. Multivariable logistic regression was used to analyze associations, and the Karlson-Holm-Breen method was employed to evaluate mediation effects.

RESULTS

The prevalence of frailty was 30.65%, with women showing a higher prevalence than men (33.16% vs. 27.85%). Older adults experiencing body pain had increased odds of frailty (adjusted odds ratio [aOR]: 1.17, 95% CI: 1.06-1.35). Depression (aOR: 1.70, 95% CI: 1.44-2.01) and insomnia symptoms (aOR: 1.58, 95% CI: 1.38-1.81) were independently associated with higher odds of frailty. Mediation analysis showed that depression mediated 8.4% of the association between pain and frailty in men and 6.11% in women. Insomnia symptoms mediated 11.47% of the association in men and 14.54% in women.

CONCLUSION

Body pain was significantly associated with a higher likelihood of frailty among older adults in India. Symptoms of depression and insomnia partially mediated this association, with a stronger mediating effect observed for insomnia in women. Inclusive health care strategies addressing pain, depression, and insomnia could help mitigate the risk of frailty in this population.