Chronic pain as a mediator in the falls-frailty association: Evidence from middle-aged and older ethnic minorities in Yunnan, China

Falls are a common unintentional event among older adults, often resulting in injuries that significantly impact health and quality of life. They have been widely recognized as a predominant challenge in geriatric nursing [1]. According to the Global Burden of Disease Study, the incidence, mortality, and disability-adjusted-life-years of falls in the Chinese population increased in rank from 27th in 1990 to 17th in 2017 [2]. Statistics show that in 2019, falls contributed significantly to the burden of disease and ranked as the second leading cause of injury-related death in China [3]. In addition to the immediate threat to life, falling also leads to various other health issues. Older adults who experience falls often face long-lasting physical and psychological consequences, with frailty being among the most common [4,5]. A cohort study indicating that seniors who experience falls are 1.92 times more likely to develop frailty [6]. Particularly noteworthy are the fall-induced consequences such as fractures, infections, and muscle injuries, which have independently been recognized as predictors of both the onset and progression of frailty [7]. This correspondence between falls and an increased likelihood of frailty in older adults has been further substantiated through comprehensive meta-analyses [8].