Chronic pain in older persons: prevalence, assessment and management

Abstract

Although the prevalence of acute pain does not increase as a result of aging, chronic pain problems tend to increase in late life. There is also limited evidence that there is a plateau or even a slight reduction in the frequency of chronic pain following the eighth decade of life. Many health conditions that affect older adults are associated with pain, and overall prevalence estimates for this population range from 25% to 65% for community-dwelling older persons, and up to 80% for seniors living in long-term care facilities. The wide variation in prevalence estimates is likely to be due to differences in survey methodologies and operational definitions of pain (e.g. ‘pain during the last week’ vs. ‘pain during the last month’). Nonetheless, a consensus view appears to converge on the conclusion that at least 50% of older persons suffer from at least one persistent or bothersome pain problem at any one point in time. Although many seniors with dementia have difficulty reporting pain due to cognitive impairment, in a large-scale investigation of nursing-home residents, it was shown that conditions that are likely to cause pain occur with equal frequency in residents with and without dementia.