Overview of persistent pain in older adults.

Abstract

With the shifting age demographics of the U.S. population, more psychologists will be asked to provide clinical services to older adults. Given the high prevalence of persistent pain in aging, in many cases this will mean providing empirically supported interventions for pain and the interference it creates. The purpose of this review is to provide a broad overview of the scope and impact of persistent pain in older people and to discuss mechanisms by which persistent geriatric pain can lead to suffering and disability. We consider the unique context of pain in older adulthood and review differences between older and younger people in terms of pain perception, the social network, beliefs about pain, pain-related coping, and adherence to pain medication. Finally, we discuss special issues affecting pain management in older adults, including dementia, polypharmacy, and barriers to accessing adequate pain care. This review also highlights a need for greater provider training in pain management to meet the needs of a changing U.S. population.

Older adults’ preferences for formal social support of autonomy and dependence in pain: development and validation of a scale

“…Considering current epidemiological data on pain and ageing, over half of older adults will likely suffer from chronic (musculoskeletal) pain (Gibson 2007;Helme and Gibson 2001;Molton and Terrill 2014;Yamada and Thomas 2011), i.e., pain that persists beyond a "conventional" tissue healing time -3 months (Merskey and Bogduk 1994). Chronic pain is often highly disabling (Reyes-Gibby, Aday and Cleeland 2002;Ferrel et al 1995;Helme and Gibson 1997) and one of the main obstacles to older adults' ability to perform physical, cognitive and social activities independently -functional autonomy (Hébert et al 2001;Sttubs et al, 2013) -and to an healthy ageing process (Wilkie et al 2013).…”

Incorporating Persistent Pain in Phenotypic Frailty Measurement and Prediction of Adverse Health Outcomes

“…First, persistent pain is readily assessable through self-report. Second, although persistent pain, such as frailty, is strongly related to age (5), it is associated with greater incidence of death, disabilities, and other adverse outcomes independent of age, disability, or medical burden (3,4). Third, persistent pain development can be understood as both cause and consequence of other frailty elements.…”

“…Because prediction of adverse outcomes is a key objective, it is important to consider additional factors that may improve prediction or frailty measurement. Persistent pain, for instance, is an independent risk factor for many adverse outcomes (3,4), occurs frequently with frailty criteria (5), and represents an important indication of physiologic vulnerability. Therefore, the purpose of this study was to evaluate the degree to which expanding frailty to include persistent pain influences frailty categorization and prediction of adverse outcomes.…”

Fatores preditores de dor em idosos do Município de São Paulo, Brasil: Estudo SABE 2006 e 2010

“…Atitudes e crenças podem estar relacionadas a situações de sofrimento físico e emocional e, consequentemente, contribuir para o tratamento eficaz da dor, pois podem alterar a percepção, relato e controle do quadro álgico pela pessoa idosa 34 .…”