Constant Pain a Big Problem in Older Adults
By Ed Susman, Contributing Writer, MedPage Today
Published: May 11, 2013
NEW ORLEANS -- Nearly 19 million older adults in the U.S. reported bothersome pain in the previous month, according to researchers here.
Based on an analysis of data from the 2011 National Health and Aging Trends Study, 18.7 million (52.3%) adults, ages 65 to 69, reported bothersome pain within the last month as did 56% those ages 90 and up, said Kushang Patel, PhD, from the University of Washington in Seattle, and colleagues at the annual meeting of the American Pain Society.
In addition, the incidence of bothersome pain in the past month did not appear to change between those in their 60s and those in their 90s.
"Those really aren't the differences we have thought we would see," Patel told MedPage Today, adding that his group had expected that pain incidence would rise significantly as people grow older, especially because the data included individuals in nursing homes.
The authors wanted to assess the burden of pain in the country's older adult population given the large numbers of them with multiple morbidities, hospitalizations, and surgical procedures. The 2011 national study included in-person interviews with over 7,000 adults, ages 65 and up, and had a response rate of 71%.
Based on the current analysis, Patel's group found the following rates of bothersome pain prevalence among various age groups:
- Ages 70 to 74: 51.9%
- Ages 75 to 79: 53.8%
- Ages 80 to 84: 51.9%
- Ages 85 to 89: 56%
Patel said that almost three-fourths of the individuals with pain said they had multiple pain sites, and that it impacted their ability to perform activities of daily living.
"For example, self-reported inability to walk three blocks was 72% higher in participants with pain than without pain," the group explained (adjusted prevalence ratio=1.72, 95% CI 1.56 to 1.90).
Compared with older adults without pain and after adjusting for other potential confounders, participants with two sites of pain had a slower gait speed of 0.03 meters/second while those with three sites of pain had a slower speed of 0.05 meters/second. Those with more than four sites of pain had a gait slower speed of 0.08 meters/second (P<0.001).
Patel said that it's been previously unclear whether pain incidence goes up with age, "but here we see that, even including persons in nursing homes, there is no particular difference in the percentage of patients with pain after age 65."
While the researchers did not look at treatment for pain, "in general, pain is undertreated in older adults." he said.
Mark Sullivan, MD, who is also from the University of Washington but did not participate in the study, told MedPage Today that "pain has a lot of functional significance for these people in terms of being able to walk, in being able to get up and down, and in being able to grasp things. So these are pretty significant."
But Sullivan said more information was needed on treatment because "a lot of times, treatments make these geriatric patients worse. With pain treatments you are looking at quality of life. Nonsteroidals, opioids, gabapentin; really common pain treatments have a pretty substantial downside in older groups."
"I think there is a second chapter about what you do about [burdensome pain] that is really going to make an overall benefit," he added.
Patel and Sullivan reported no conflicts of interest.
Primary source: American Pain Society