The Role of Pain in the Last Year of Life of Older Persons

Abstract

A random sample of 200 decreased older community residents was studied with a focus on the role of pain in the last year of life. Interviews with a surviving close person elicited retrospective reports. Pain increased over the final year; one month before death 66% felt pain frequently or all of the time, substantially higher than a matched comparison group of living persons (24%). For both groups across the year, pain was associated with most measures of behavioral competence, perceived quality of life, and psychological well-being. Hierarchical multiple regressions indicated that background and health variables explained 28% to 32% of the variance of pain over the year. Controlling for background variables and health, pain contributed significantly to lowered happiness and to depression, but had no independent impact on hope and interest in the world. After controlling for physical health, the older old were judged to have less pain than the younger old.

Reciprocal relationship between pain and depression in elderly Chinese primary care patients

“…However, the studies on the relationship between pain and depression among primary care elderly patients are scarce. Most research is based on community-residing elderly people (Moss et al, 1991;Ohayon, 2004), nursing home residents (Parmelee et al, 1991;Cohen-Mansfield and Marx, 1993), or a population of older adults with a particular medical condition (Williamson and Schulz, 1995;Sharpe et al, 2001;Lackner et al, 2004). The purpose of the present study was to examine the reciprocal relationship between pain and depression among elderly Chinese primary care patients in Hong Kong.…”

“…The relationship between pain and depressive symptoms has been well demonstrated in community-dwelling elderly adults (Cook et al, 1989;Moss et al, 1991;Williamson and Schulz, 1992), but the reciprocal and temporal relationship between these two syndromes is less clear (for an exception see Geerlings et al, 2002). It is clearly plausible that each syndrome may lead to the other.…”

Longitudinal relationship between pain and depression in older adults: sex, age and physical disability

“…An association between pain and depression in older adults has been demonstrated consistently [4][5][6][7][8][9]. However, this association is less than straightforward.…”

Are all Older Adults with Persistent Pain Created Equal? Preliminary Evidence for a Multiaxial Taxonomy

“…Abundant evidence indicates that primary care providers undertreat pain in older adults (10)(11)(12), which results in unnecessary suffering, including compromised functional status (13)(14)(15)(16)(17)(18)(19), depression and anxiety (15,(20)(21)(22)(23)(24), disturbed sleep (16,25,26), worsening cognitive function (27)(28)(29)(30), diminished quality of life (31,32) and increased utilization of health care resources (33,34). Because of the multidimensional nature of persistent pain, that is, because its experience is influenced by sensory input, psychosocial and behavioural processes (35,36), logic suggests that it might optimally be managed by an interdisciplinary team of providers (eg, physical therapy, occupational therapy, psychology and pain medicine specialist).…”