Chronic pain and geriatric syndromes in community-dwelling patients aged ≥65 years (original) (raw)
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Chronic pain and geriatric syndromes in community-dwelling patients aged ≥65 years
Journal of Pain Research
Beer-sheva, israel; 4 Yasski clinic, comprehensive geriatric assessment Unit, clalit health services, Beersheva, israel; 5 Unit for community geriatrics, Division of health in the community, Ben-gurion University of the negev, Beer-sheva, israel Background: In growing elderly populations, there is a heavy burden of comorbidity and a high rate of geriatric syndromes (GS) including chronic pain. Purpose: To assess the prevalence of chronic pain among individuals aged ≥65 years in the Southern District of Israel and to evaluate associations between chronic pain and other GS. Methods: A telephone interview was conducted on a sample of older adults who live in the community. The interview included the Brief Pain Inventory and a questionnaire on common geriatric problems. Results: Of 419 elderly individuals who agreed to be interviewed 232 (55.2%) suffered from chronic pain. Of those who reported chronic pain, 136 participants (68.6%) noted that they had very severe or unbearable pain. There were statistically significant associations between the pain itself and decline in patient's functional status, increased falls, reduced mood, and cognitive decline. Conclusion: The results of this study show that chronic pain is very common in older adults and that it is associated with other GS. There is a need to increase awareness of chronic pain in older adults and to emphasize the important role that it plays in their care.
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.
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 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.
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.
OA elderly medicine, 2013
Introduction Chronic pain in the elderly is frequent, often under-recognised and undertreated, resulting in poor quality of life. Because of the ageing population in the developed world, it represents a growing problem, with substantial socioeconomic consequences. Apart from often being multi-factorial, its treatment is complicated by co-morbidities and increased susceptibility to medical side effects. Effective pain relief may require a multidisciplinary approach and non-pharmacologic therapies. This review aims to address the critical aspects of the causes, recognition and treatment of chronic pain in the elderly. Conclusion The management of pain remains a challenge, and besides the administration of analgesics, may require a multidisciplinary approach and the application of non-pharmaceutical therapeutic interventions.
Medical Science Monitor, 2019
Background: The prevalence of chronic pain among the elderly is high (estimated at 25-85%) and may adversely affect their everyday functioning, although it is often unrecognized. Material/Methods: The aim of this study was to assess the prevalence of chronic pain, especially with the neuropathic component, and its effect on overall functioning of elderly patients. We enrolled 145 subjects older than 60 years (nursing home residents, or patients of outpatient geriatric clinic). Information on co-morbidities, functional and mental status, and medications was obtained using a questionnaire. Chronic pain was defined as lasting >3 months and the presence of neuropathic component was detected using the DN4 Questionnaire (Douleur Neuropathique en Questions). Results: The mean age of patients was 76±9.68 years. Chronic pain was reported by 78% of participants and 32% reported neuropathic pain with neuropathic component (DN4 score ³4 points). Patients complaining of chronic pain significantly more often presented mood disorders and lower satisfaction with life (particularly those with the highest pain intensity), with no difference in functional status according to the ADL (Activities of Daily Living) tool. Participants with chronic pain were treated with paracetamol (45%), non-steroidal anti-inflammatory drugs (25%), and opioids (24%). Conclusions: The prevalence of chronic pain, particularly with neuropathic component, in the elderly population seems to be higher than expected based on previous reports, and its treatment appears to be ineffective. This problem requires further research and dissemination of knowledge on the diagnosis and treatment of chronic pain among health care workers caring for elderly patients on a daily basis.
Overall and health related quality of life among the oldest old in pain
Quality of Life Research, 2000
Objectives: To compare the oldest old (85 years and above) in pain with those with no pain across gender, regarding demographic data, living conditions, social network/support, walking/mobility problems, fatigue, sleeping problems, depressed mood and quality of life (QoL). The aim was also to test how these variables were related to QoL among the oldest old in pain. Methods: The study comprised 1622 people aged 85-105 years, of whom 47% reported pain. SF-12 and the LGC questionnaire were used to measure QoL. Multiple linear regression analysis was used to identify factors associated with QoL. Results: Functional limitations, fatigue, sleeping problem and depressed mood were significantly more prevalent and QoL was significantly lower among those in pain than those not in pain, and among women compared to men. These complaints, along with financial problems, living in sheltered housing and living alone, were associated with low QoL among those in pain. Conclusion: Pain is common among the oldest old and coexists with several other complaints that together negatively affect QoL. By identifying those in pain and coexisting factors, actions can be taken to contribute to QoL, also in late life.
Romanian Journal of Neurology, 2022
Background. Pain is one of the most common health problems often experienced by the elderly. Research on pain and its comorbidities in elderly are crucial, because it relates to disability and impairment in quality of life. Unfortunately research related to pain in the elderly and co morbidities are still limited in Indonesia, better understanding about pain can be a vital consideration of treatment and drug consideration. This study was conducted to provide an overview of pain and its comorbidities in elderly. Materials and methods. This was an observational cross sectional study to 949 subjects. Subjects were recruited from outpatients neurology department in 10 big cities Hospitals in Indonesia. Data obtained from subjects who completed the self-made pain questionnaire and medical records. Subjects were characterized based on type of pain, location of pain, properties of pain, time of exacerbation, and comorbidities. All data were processed descriptively. Results and conclusion. A total of 949 subjects met the inclusion criteria. The subjects consist of 476 (50.16%) female and 473 (49.84%) male, with common age group between 60-74 years (80.08%). The Most common pain characteristic are mild pain intensity (46.79%), mixed type of pain (44.68%), chronic pain (64.59%), multiple site pain location (45.42%) and uncertain time pain exacerbation (37.40%). Six hundred and eighteen (65.12%) subjects have comorbidity and 331 (34.88%) without comorbidity. The most common comorbidity found were hypertension (41.31%) and diabetes (14.23%), with 561 (90.78%) subjects have 1 comorbidity. These study provide the overview of the geriatric problems especially in pain and the comorbidities so that the clinician can provide a comprehensive management of pain problems in geriatric.