PURPOSE: Frailty has been demonstrated to correlate with chronic pain (CP). This study aimed to estimate the risk of frailty/pre-frailty and evaluate the potential bidirectional relationship between frailty/pre-frailty and CP. METHODS: A systematic search was conducted across ten databases, covering literature from their inception through November 23, 2024. Two independent reviewers screened relevant studies, assessed study quality, and extracted data. All analyses were performed using R software, version 4.3.1. RESULTS: A total of 25,904 participants aged ≥ 60 years were included in 33 studies. CP significantly increased the risk of frailty (OR = 1.91, 95 % CI: 1.47-2.47
I CONCLUSIONS: No evidence supports a bidirectional relationship between frailty/pre-frailty and CP. Nonetheless, addressing and managing CP in older adults may mitigate the risk of frailty and promote healthy aging.