Sarcopenia and Chronic Pain in the Elderly: A Systematic Review and Meta-Analysis

Abstract

Objective: Sarcopenia and chronic pain are prevalent among older adults, and despite numerous studies, the potential epidemiological link between the two conditions remains a topic of controversy. Therefore, we performed a comprehensive systematic review and meta-analysis to assess the relationship between chronic pain and sarcopenia in the elderly.

Methods: EMBASE, Web of Science, PubMed, and the Cochrane Library were searched through 22 March 2023 with additional manual searches of reference lists of included studies and relevant reviews. We used a random effects model to conduct the meta-analysis and evaluated heterogeneity across studies with Cochran's Q statistic and I². Subgroup analyses were conducted based on income level, diagnostic criteria for sarcopenia, and pain site.

Results: 17 observational studies (33,600 participants, 49% female) were included, of which 6 articles were retrieved for narrative review. The pooled prevalence of sarcopenia and the pooled odds ratios (OR) between chronic pain and sarcopenia were extracted from the remaining 11 studies. The pooled prevalence of sarcopenia among older adults suffering from chronic pain was 0.11 (95% CI, 0.08-0.18). Our analysis revealed a statistically significant positive association between chronic pain and an increased risk of sarcopenia, yielding a pooled OR of 1.52 (95% CI, 1.31-1.76). Furthermore, our subgroup analysis demonstrated that the low-income countries group showed a stronger association (OR, 1.73; 95% CI, 1.54-1.95) between chronic pain and sarcopenia than the high-income countries group (OR, 1.38; 95% CI, 1.20-1.60).

Conclusion: Older adults with chronic pain have a significantly higher prevalence of sarcopenia and risk of developing sarcopenia compared to those without pain. These findings highlight the importance of prioritizing the assessment and early detection of chronic pain in older people, as well as implementing proactive intervention measures in clinical practice. In addition, our results suggest that older people with chronic pain should be actively screened for sarcopenia.

Prospero registration number: CRD42021239807.

Keywords: chronic pain; meta-analysis; sarcopenia; the elderly.