Pain in Older People (original) (raw)

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The epidemiology of pain in elderly people

Clinics in Geriatric Medicine, 2001

Acute pain probably occurs at much the same rate across all age groups. On the other hand, self-report of chronic pain seems to increase up to, but not beyond, the seventh decade of life. Chronic pain in older people is more often experienced in major joints, the back, legs and feet, whereas visceral pain and headache are reported less often. There is a divergence between an increasing load of pain-associated disease and a plateau of chronic pain complaint in old age that probably reflects impairment in the nociceptive function of the nervous system. However, the contribution of social, behavioral, cognitive, and affective dimensions of the pain experience to this divergence between disease and pain have not been fully evaluated. Most of the answers to these and other questions require longitudinal studies with pain as the predominant focus of attention rather than addressing the symptom of pain as an ancillary measure relevant to other aspects of aging.

Prevalence and Relevance of Pain in Older Persons

Pain Medicine, 2012

Setting. With the ageing of the world's population, any health problem which adversely affects quality of life in older persons becomes increasingly salient. Persistent pain is one of the most prevalent health conditions faced by adults of advanced age, and is recognized as a major concern for this segment of the population. Results. Numerous epidemiologic surveys suggest that pain is most common during the late middleaged phase of life (55-65 years) and continues at approximately the same prevalence into older age (65+). This is true regardless of the anatomical site or the pathogenic cause of pain. The one exception appears to be pain associated with degenerative joint disease (e.g., osteoarthritis) which shows an exponential increase until at least 90 years of age. Common age associated conditions like dementia may result in a reduced frequency and intensity of pain. Daily pain is a major risk factor for developing disability and the oldest age cohorts are most vulnerable. Discretionary and higher order physical activities appear most affected, while basic activities of daily living may be modified but are rarely ceased altogether. Similar relationships have been documented for risk of depression and mood disturbance in older persons with persistent pain. Despite such well characterized adverse impacts, pain often remains poorly treated in older persons. This occurs across all health care settings examined (i.e., emergency, acute, outpatient, long-term care). Conclusion. Improved knowledge for both health professionals and patients, addressing the current research gaps and expansion of age-appropriate pain management services will be required to better meet the needs of our rapidly ageing population.

Pain Experience of the Elderly

Pain Management Nursing, 2010

Too often, the elderly suffer silently and needlessly with chronic pain. To investigate the pain experience of the elderly living in the community, a descriptive research design was used. The aims of the study were to determine the prevalence of pain in an older population living in the community, to obtain a description of the older adult's pain experience, and to determine strategies used to manage their pain. The results of the study indicated that >90% of the elderly living in the community experienced pain within the past month, with 41% reporting discomforting, distressing, horrible, or excruciating pain. Musculoskeletal pain was found to be the most predominant pain, and inactivity was the most effective strategy used to lessen pain. Pain in the elderly continues to be a challenge which needs to be addressed more effectively by health care providers. Based on the high prevalence of pain experienced by the elderly and the expected demographic shifts in the next two decades, it is imperative to continue research in this area to assure the highest quality of life, as well as maximum functional ability, for the elderly. Health care providers need to understand the multidimensional pain experience that occurs in the daily life of the community-dwelling older adult and the most effective management strategies that can be used to provide pain relief.

Old people in pain: A comparative study

Journal of Pain and Symptom Management, 2003

To investigate the prevalence of pain in older people (75ϩ), compare those in pain to those without regarding demographics, social network, functional limitations, fatigue, sleeping problems, depressed mood and quality of life (QOL), and identify variables associated with pain, a cross-sectional, prospective survey was conducted in an age-stratified sample of 4,093 people aged 75-105 years old. Those reporting pain (n ϭ 1,654) were compared with those who did not (n ϭ 2,439). Pain was more common with higher age, as were all complaints among those in pain and among those without, except sleeping problems. Lower QOL was found with higher age, as well as with pain. Pain was found to be associated with functional limitations, fatigue, sleeping problems, depressed mood, and QOL. These data highlight the importance of identifying old people in pain. Those who are older and those affected by pain are at greater risk of also being troubled by other problems, such as functional limitations and lowered QOL. J Pain Symptom Manage 2003;26:625-636.

Pain Perceptions of the Oldest Old: A Longitudinal Study

The Gerontologist, 2004

This study assessed self-reported pain in the oldest old and examined its changes over time and in relation to other measures of health and functioning. Design and Methods: A population-based sample of the oldest old (86-92 years of age) residing in Sweden who were participating in a multiwave longitudinal investigation were interviewed about their experience of pain, as well as other dimensions of health and functioning. Results: Prevalence of pain at baseline was 34% and rose to 40% at follow-up. Incidence of new pain cases during that period was 16 percent. Pain was significantly related to sleep difficulties, medication usage, global subjective health, depressive symptoms, and mobility, though the magnitude of the associations was relatively small. Implications: Our results extend previous cross-sectional findings by demonstrating there is both an increase in the proportion of people reporting pain over time after the age of 85 as well as the possibility of recovery. The modest strength of associations of pain with other areas of functioning suggests adaptation and selectivity among survivors in very late life.

Assessment and measurement of pain in older adults

Clinics in Geriatric Medicine, 2001

Although the empirical base is still limited when providing clear directions for pain assessment and management in older adults, it is possible to identify recommendations for guiding practice based on consensus and a developing scientific base to support best practice activities. This article offers a brief overview of the epidemiology and consequences of pain, followed by a summary of issues and approaches relevant to pain assessment in older adults. Cohort specific recommendations for comprehensive pain assessment and measurement are then addressed.

Age-related differences in pain perception and report

Clinics in Geriatric Medicine, 2001

The older person faces many threats to quality of life, including a marked increase in the incidence of disease, higher levels of functional disability, loss of lifetime partner or friends and family support networks, reductions in economic resources, and the foreboding prospect of institutional placement with an associated loss of independence. Even within this context, however, the presence of severe, unremitting pain is often regarded as one of the most common and devastating threats to healthrelated quality of life.94, '@ Recent epidemiologic studies indicate that more

Pain in elderly patients: a neglected phenomenon

Journal of advanced nursing, 1994

The assessment and control of pain in elderly patients present unique problems. Old people are likely to experience more pain, both chronic and acute, than their younger counterparts. Demographic changes mean that larger numbers of older patients will require effective and efficient control of pain in order to optimize their quality of life. Relatively little research has focused on this potentially huge problem. This paper discusses issues specific to pain in elderly people, and suggests that wide ranging and careful assessments are needed. Benefits can be achieved not only from the appropriate use of analgesic drugs, but also physical and psychological therapies.

Longitudinal Patterns of Pain Reporting Among Community-dwelling Older Adults

The Clinical Journal of Pain, 2020

Objective: The objective of this study was to identify and describe long-term trajectories of bothersome pain and activity-limiting pain in a population-based sample of older adults. Materials and Methods: We conducted a retrospective cohort study of 6783 community-dwelling participants using 6 years of longitudinal data from the National Health and Aging Trends Study (NHATS). NHATS is a cohort of older adults that is representative of Medicare Beneficiaries aged 65 years and older. NHATS data collection began in 2011, and demographic and health data are collected annually through in-person interviews. Participants were asked if they had bothersome pain and activity-limiting pain in the past month. We used group-based trajectory modeling to identify longitudinal patterns of bothersome pain and activity-limiting pain over 6 years. We used weighted, multinomial logistic regression to examine associations with each trajectory. Results: The cohort was 57% female, 68% white, and 58% were 75 years and older. Four trajectories were identified for the probability of bothersome pain: persistently high (n = 1901, 35%), increasing (n = 898, 17%), decreasing (n = 917, 17%), and low (n = 1735, 32%). Similar trajectories were identified for activity-limiting pain: persistently high (n = 721, 13%), increasing (n = 812, 15%), decreasing (n = 677, 12%), and low (n = 3241, 60%). The persistently high bothersome and activitylimiting pain groups had worse health characteristics, were more likely to have fallen in the past year, and had slower gait speed and worse physical capacity compared with the low groups. Discussion: Approximately one half of older adults had a high or increasing probability of long-term bothersome pain, and over one quarter had a high or increasing probability of long-term activitylimiting pain.