Age and Race Effects on Pain Sensitivity and Modulation Among Middle-Aged and Older Adults

Abstract

This study tested the effects of aging and race on responses to noxious stimuli using a wide range of stimulus modalities. The participants were 53 non-Hispanic Blacks and 138 non-Hispanic White adults, ages 45 to 76. The participants completed a single 3-hour sensory testing session where responses to thermal, mechanical, and cold stimuli were assessed. The results suggest that there are selected age differences, with the older group less sensitive to warm and painful heat stimuli than middle-aged participants, particularly at the knee. This site effect supports the hypothesis that the greatest decrement in pain sensitivity associated with aging occurs in the lower extremities. In addition, there were several instances where age and race effects were compounded, resulting in greater race differences in pain sensitivity among the older participants. Overall, the data suggest that previously reported race differences in pain sensitivity emerged in our older samples, and this study contributes new findings in that these differences may increase with age in non-Hispanic Blacks for temporal summation and both heat and cold immersion tolerance. We have added to the aging and pain literature by reporting several small to moderate differences in responses to heat stimuli between middle and older age adults.

Age-related differences in conditioned pain modulation of sensitizing and desensitizing trends during response dependent stimulation

“…This result confirms other demonstrations of an inhibitory effect of CPM on pain [1–4,36]. However, the reduction in pain sensitivity following CPM was comparable for younger and older subjects in the present study, whereas previous studies have described less inhibition for older subjects [4,12–15] or inhibition for young and facilitation for older subjects during CPM paradigms [16,20]. An important factor in these differences may be the oscillations in stimulation intensity during long duration REDSTIM that could mask or interfere with other sources of inhibition or facilitation.…”

Pain Assessment in People With Dementia: Remaining Controversies

“…Some research studies have revealed that pain may be less frequent and less severe in PWD suffering from some acute medical conditions (Gibson, 2015;Hadjistavropoulos et al, 2015;Pignataro & Swisher, 2010). Two recent studies (Riley et al, 2014;Stabell, Stubhaug, Flaegstad, & Nielsen, 2013) have revealed that pain threshold increases with age. However, a recent study revealed that whether there is no change or decrease in pain thresholds as age advances (Leegaard, Lomholt, Thastum, & Herlin, 2013).…”

Chronic Pain in Older Adults

“…14 The threshold for pain may vary based on the type of stimulus (increase with heat, no change with electrical stimulation, decrease with mechanical pressure and ischemia), duration (increase with shorter duration), and location (increase at peripheral or visceral site). 13,15,16 Although pain may not serve as a reliable warning sign of tissue damage in some atypical clinical presentations (cardiac ischemic pain, abdominal pain) because of the increased pain threshold, this finding should not lead to the conclusion that most of the older adult population will not experience pain. 17,18 Rather, the increased pain threshold that accompanies aging may imply that more significant levels of underlying pathologic disorder may be present in older adults who endorse pain.…”