Significant Association Noted Between Sarcopenia and Pain in Older Adults

The prevalence of sarcopenia among patients with pain is relatively high, and pain is significantly associated with sarcopenia in older adults, according to results of a systematic review and meta-analysis published in the Journal of Post-Acute and Long-Term Care Medicine (JAMDA).

A systematic review and meta-analysis was conducted, in which the prevalence of sarcopenia among patients with pain was assessed. Study authors also determined whether pain was independently associated with sarcopenia.

Studies were eligible for inclusion if they were cross-sectional, case-controlled, and cohort-based in design; if they  were validated and recognized consensus or scale used for a diagnosis of sarcopenia, or fulfilled 1 of the diagnostic components of low muscle mass, low muscle strength, or low physical performance; if they calculated the prevalence or odds ratios (ORs) of sarcopenia in patients with pain, including a case group of patients with both sarcopenia and pain, as well as a control group with pain but no sarcopenia; if they reported a number of different categories of relevant pain; and if they did not have restrictions with regard to language and location.

From the initial database search, a total of 27,962 articles, with 120 relevant articles, were retained following screening of the titles and abstracts. Based on the eligibility criteria, 14 studies were included in the qualitative review and 10 studies were selected for the meta-analysis.

A total of 14 observational studies, with 13,953 enrolled participants (44.1% women), were included in the analysis, with the average age of participants between 40.1 years and 76.6 years. Among the study participants, 2855 reported pain and 242 were diagnosed with sarcopenia.

The overall prevalence of sarcopenia in patients with pain was 0.11 (95% CI, 0.07-0.15; P <.001). Individuals with vs without pain had an independent association with a higher risk for sarcopenia (OR, 1.35; 95% CI, 1.17-1.56; P =.025).

Subgroup analysis demonstrated that the cumulative prevalence and effect measures of sarcopenia were increased among patients with secondary musculoskeletal pain (prevalence, 12%; OR, 1.45; 95% CI, 1.19-1.78) and low back pain (prevalence, 21%; OR, 1.95; 95% CI, 1.22-3.12).

Limitations of the meta-analysis included the fact that most of the studies adopted a cross-sectional design, from which it was not possible to elucidate the causal relationship between sarcopenia and pain. In addition, significant heterogeneity existed among the included studies regarding diagnostic methods, measurement approaches, and diagnostic thresholds.

The researchers concluded, “In future clinical practice, attention should be given to screening for sarcopenia in patients with pain, and the mutual influence of sarcopenia and pain should be recognized…Some interventions, such as appropriate exercise and activity, should be considered, as they are supposed to reduce pain and increase muscle mass.”

Reference

Lin T, Dai M, Xu P, et al. Prevalence of sarcopenia in pain patients and correlation between the two conditions: a systematic review and meta-analysis. J Am Med Dir Assoc. Published online March 23, 2022. doi:10.1016/j.jamda.2022.02.005