Pain in the elderly

Human population aging is a recent phenomenon in the history of humankind and is increasing in the last 50 years, no longer being limited to developed countries but becoming a worldwide phenomenon bringing with it specific age-related morbidities and others which become more frequent with aging. Pain is part of the second category and is more frequent in the elderly than in younger individuals¹.

The prevalence of pain is very high among the elderly, varying from 25% to 80%¹Among the elderly living in the community, the prevalence varies from 25% to 53%^1,2 and among those living in long-term care facilities, the prevalence is even higher, being that 45% to 80% have moderate to severe pain and are undertreated^3,4. These elderly coming from the community and from long-term care facilities often have different pain etiologies, and the presence of cognitive and sensory changes and incapacities of different origins makes even more difficult pain evaluation and diagnosis⁵.

Acute and chronic pains are major obstacles for better quality of life and, in the elderly, are one of the most important causes of morbidity, because they are strongly related to inability to have a healthier and independent life, due to major functional limitations, even for simple daily activities, such as walking⁶.

In this edition of Revista Dor, authors Santos et al.⁷ have addressed the issue of pain in the elderly, estimating the prevalence of chronic pain in more than 300 long-lived patients with functional independence of a community in the city of São Paulo, evaluating their characteristics and correlating chronic pain with vitamin D serum levels. They have observed high prevalence of chronic pain, however interestingly lower than other studies of pain in the elderly. Although the expressive number of patients with vitamin D deficiency, it was not possible to establish correlation between low vitamin D serum levels and chronic pain.

This study brings to light the problem of painful syndromes among this population in a country with increasingly more elderly and long-lived, clearly showing that understanding pain and promoting analgesia for such patients are major challenges. The need for studies with this population is unquestionable and will remain as such for some time, especially in countries with deficits of evaluations in this area.

REFERENCES

• ¹
  Helme RD, Gibson SJ. Pain in older people. In: Crombie, IK, Croft PR, Linton SJ, et al, eds. Epidemiology of Pain. Seattle; IASP Press: 1999. 103-12p.
• ²
  McCarthy LH, Bigal ME, Katz M, Derby C, Lipton RB. Chronic pain and obesity in elderly people: results from the Einstein aging study. J Am Geriatr Soc. 2009;57(1):115-9.
• ³
  Ferrell BA. Pain evaluation and management in the nursing home. Ann Intern Med. 1995;123(9):681-7.
• ⁴
  Bernabei R, Gambassi G, Lapane K, Landi F, Gatsonis C, Dunlop R, et al. Management of pain in elderly patients with cancer. SAGE Study Group Systematic Assessment of Geriatric Drug Use via Epidemiology. JAMA. 1998;279(23):1877-82.
• ⁵
  Sengstaken EA, King SA. The problems of pain and its detection among geriatric nursing home residents. J Am Geriatr Soc.1993;41(5):541-4.
• ⁶
  Andrews JS, Senzer IS, Yelin E, Covinsky KE. Pain as a risk factor for disability or death. J Am Geriatr Soc. 2013;61(4):583-9.
• ⁷
  Santos FC, Moraes NS, Pastore A, Cendoroglo MS. Dor crônica em idosos longevos: prevalência, características, mensurações e correlação com nível sérico de vitamina D. Rev Dor. 2015;16(3):171-5.

Publication Dates

• Publication in this collection
  Jul-Sep 2015