Pain Intensity and Frailty in Patients With Knee Osteoarthritis: The Multiple Mediation Effect of Pain Catastrophizing and Fear of Movement.

OBJECTIVES: This study aimed to determine whether the relationship between pain intensity and frailty in patients with knee osteoarthritis (KOA) was mediated by pain catastrophizing and fear of movement (FOM). METHODS: Patients with KOA aged 45 years or above were recruited from June to August 2024. Cross-sectional data on the patients' pain intensity, frailty, pain catastrophizing, and FOM were collected using questionnaires. Correlation analysis was performed to analyze the relationship between variables, and multiple mediation effects were analyzed using AMOS 28.0 software. RESULTS: Frailty was positively correlated with pain intensity (r = 0.390, p < 0.001), pain catastrophizing (r = 0.426, p < .001) and FOM (r = 0.472, p < .001). Pain catastrophizing and FOM played multiple mediating roles in the correlation between pain intensity and frailty. CONCLUSIONS: These findings contribute to the understanding of the modifiable factors that can prevent frailty in patients with KOA. Future therapeutic interventions targeting pain catastrophizing and FOM could help prevent frailty.