COPD, pain and frailty in middle-aged and older adults: a nationwide cohort from China

The extent to which Chronic obstructive pulmonary disease (COPD) is related to frailty through pain remains unclear. This study was conducted to explore the combined effect of COPD and pain on the occurrence of frailty, and to examine mediating role of pain within that connection. This study involved a total of 13,301 participants from the China Health and Retirement Longitudinal Study (CHARLS 2011-2016). We used Kaplan-Meier (KM) curves to explore the joint effect of COPD and pain on the risk of frailty during follow-up. Cox models were used for multivariable adjusted regression analysis and mediation analysis. Our longitudinal study demonstrates that both COPD and pain independently and jointly increase frailty risk, with pain serving as a partial mediator (22.82 %) in this relationship. These findings highlight the clinical importance of integrated management addressing both respiratory symptoms and pain in COPD patients to mitigate frailty risk.