Age differences in cognitive–affective processes in adults with chronic pain

Abstract

Background: Chronic pain is associated with significant physical and psychological impairments across the adult lifespan. However, there is a relative gap in knowledge on individual differences that predict pain-related functioning. The current study highlights one important source of individual variation: age. Methods: We used cross-sectional data from a large treatment-seeking cohort of 2,905 adults (M age = 46.6 [13.1]; 71.8% women) presenting to a tertiary pain centre in the United Kingdom to determine age differences in cognitive-affective processes (catastrophizing, acceptance, self-efficacy), including their differential patterns and effects on disability and depression. Results: Older adults (ages 65-75) were found to experience higher pain acceptance and pain self-efficacy compared to both middle-aged (ages 40-64) and young adult (ages 18-39) age groups. Older adults also experienced lower levels of catasophizing compared to middle-age adults. Testing age as a moderator, we found that the relationships of pain self-efficacy and acceptance with depression as well as the relationship between pain self-efficacy and disability were comparatively weakest among older adults and strongest among young adults. Similarly, the relationship between pain catastrophizing and depression was relatively stronger for young and middleaged adults compared to older adults. Conclusions: Age-related differences in psychological mechanisms that influence pain-related functioning present unique challenges and opportunities for scientists and clinicians to improve our understanding and treatment of pain across the lifespan. Additional work is needed to refine our knowledge of age-related differences in cognitive-affective, biopsychosocial dimensions of chronic pain and to develop and test the efficacy of age-tailored interventions. Significance: Our cross-sectional analysis of 2,905 treatment-seeking adults with chronic pain presenting to a tertiary care center in the United Kingdom revealed distinct age differences in cognitive-affective linked to disability and depression.This study contributes to the limited knowledge on age-related variance in psychological mechanisms underlying adjustment to chronic pain. Promising avenues for future research include refining our understanding of age-related differences in How to cite this article: Murray CB, Patel KV, Twiddy H, Sturgeon JA, Palermo TM. Age differences in cognitive-affective processes in adults with chronic pain.

Chronic Pain in the Elderly: Mechanisms and Perspectives

“…This evidence allows suggesting that elders might have poorer outcomes concerning the emotional processing of pain, regardless of the reduction in pain sensitivity. In contrast, a clinical study revealed that older adults aging from 65 to 75 years, presenting with chronic pain diagnosis, had a superior pain acceptance and self-efficacy, with less catastrophizing levels, in comparison with middle-aged and young adults ( Murray et al, 2021 ). Thus, older individuals apparently perform better with pain experiences, with inferior levels of pain-related depression and disability when contrasted with younger individuals.…”

Associations between Objectively Determined Physical Activity and Cardiometabolic Health in Adult Women: A Systematic Review and Meta-Analysis

“…Publication bias was assessed through Egger’s test and funnel plots using at least ten studies [ 34 ]. Subgroup analyses were conducted to examine the potential sources of heterogeneity, including age (young (18–39 years old)/middle-age (40–64 years old)/both) [ 35 ], BMI (BMI < 25/BMI ≥ 25), menopausal status (postmenopausal/premenopausal/both), country, and ethnicity. All statistical analyses were performed with Review Manager, version 5.4.1 (The Cochrane Collaboration, London, UK, 2020).…”

Cutting the cord? Parenting emerging adults with chronic pain

“…In pain research, emerging adults are often grouped with cohorts of adolescents and adults. This is a disservice as emerging adulthood is a distinct developmental stage and thus the needs of emerging adults living with chronic pain are unique 16 . For example, emerging adults with chronic pain are often transitioning from pediatric to adult care for their pain treatment, which may also coincide with the transition to living independently to join the workforce, enlist in the military, and/or attend university 17,18 …”

“…This is a disservice as emerging adulthood is a distinct developmental stage and thus the needs of emerging adults living with chronic pain are unique. 16 For example, emerging adults with chronic pain are often transitioning from pediatric to adult care for their pain treatment, which may also coincide with the transition to living independently to join the workforce, enlist in the military, and/or attend university. 17,18 The aim of this narrative review is to propose a framework for understanding the role of parents (eg, parental distress and helicopter parenting) in the chronic pain experience of an emerging adult.…”