Frailty index and chronic pain in middle-aged and older Chinese adults: a cross-sectional study
In a cross-sectional survey of adults aged 45 and older in China, a higher corrected modified frailty index was associated with more chronic pain, including low back and multisite pain; depression may explain part of this link. [1]
Automatic summary · not editorially reviewed
The key findings
The cross-sectional study included 5821 participants aged 45 or older from the 2011 baseline wave of the China Health and Retirement Longitudinal Study. [1]
Compared with the lowest frailty quartile, the highest quartile had higher odds of low back pain and multisite pain and a higher rate of pain sites. [1]
Depression mediated about 30% of the associations, and the authors note that the cross-sectional design cannot establish direction. [1]
The source at a glance
- Study type / format
- Population-based cross-sectional study with mediation analysis (abstract)
- Population / context
- Adults aged 45 or older in the 2011 baseline wave of the China Health and Retirement Longitudinal Study.
- Summary based on
- Study abstract
- Original publication
- October 1, 2026
Frailty index and self-reported pain in CHARLS participants
The study asked whether overall frailty, measured with the corrected modified frailty index (CMFI), is linked to chronic pain in middle-aged and older adults. The CMFI reflects accumulated health impairments across several dimensions. The data came from 5821 participants aged 45 or older in the 2011 baseline wave of the China Health and Retirement Longitudinal Study. Chronic pain was assessed by self-report questionnaire and covered low back pain, pain at multiple sites, and the number of pain sites. This was a cross-sectional study, so frailty and pain were measured at the same time rather than one before the other.
Supporting source [1]
Highest frailty quartile linked to more pain sites
Analyses used data from 5281 participants. Compared with the lowest CMFI quartile, the highest quartile showed higher odds of low back pain (odds ratio 11.6, 95% confidence interval 8.96–15.0), of multisite pain (odds ratio 17.0, 95% confidence interval 13.1–22.2), and a higher rate of pain sites (incidence rate ratio 11.5, 95% confidence interval 8.90–14.8). Associations differed across subgroups defined by age, education and residence. Depression mediated about 30% of these associations; the abstract also mentions a possible role of C-reactive protein. These are associations, not evidence that frailty causes pain.
Supporting source [1]
Cross-sectional design limits causal conclusions
The authors conclude that higher CMFI levels were associated with greater risk and burden of chronic pain, with depression potentially accounting for part of the association. They suggest including mental health assessments in frailty and pain management for the middle-aged and older adults studied. Because the design is cross-sectional, the direction of any relationship cannot be established from this abstract. The abstract does not report follow-up, and the full text was not reviewed.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. The cross-sectional design cannot establish whether frailty precedes pain or vice versa, and the abstract reports no follow-up.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Cheng Y, Ji Y, Bai Y. · europepmc.org · October 1, 2026