Advertisement

Healthy Aging pp 305-312 | Cite as

Pain and Healthy Aging

  • Fabio Guerriero
  • M. Carrington Reid
Chapter

Abstract

Healthy aging has been defined as the “development and maintenance of optimal mental, social and physical well-being and function in older adults” [1]. Preventing and managing pain in later life is critical to help individuals achieve healthy aging, maintain independence, and preserve autonomy. This chapter reviews the epidemiology of pain in older adults, summarizes differences in pain perception as a function of age, and describes recent evidence regarding the impact of pain on function and quality of life in older adults. We also provide recommendations for practical methods to assess pain in older adults, summarize key primary prevention efforts that clinicians can implement to reduce the occurrence of new cases of persistent pain, and present management strategies that are appropriate for use in the era of the opioid epidemic.

Keywords

Persistent pain Disability Older adults Pain assessment Pain management 

Notes

Funding

Dr. Reid is supported by grants from the National Institute on Aging (P30AG022845, K24AGO53462) and by the Howard and Phyllis Schwartz Philanthropic Fund.

References

  1. 1.
  2. 2.
    https://www.iasp-pain.org/Taxonomy. Accessed 28 Feb 2018.
  3. 3.
    Blyth FM, March LM, Brnabic AJ, Jorm LR, Williamson M, Cousins MJ. Chronic pain in Australia: a prevalence study. Pain. 2001;89(2–3):127–34.PubMedCrossRefGoogle Scholar
  4. 4.
    Covinsky KE, Lindquist K, Dunlop DD, Yelin E. Pain, functional limitations, and aging. J Am Geriatr Soc. 2009;57(9):1556–61.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Patel KV, Guralnik JM, Dansie EJ, Turk DC. Prevalence and impact of pain among older adults in the United States: findings from the 2011 National Health and Aging Trends Study. Pain. 2013;154(12):2649–57.  https://doi.org/10.1016/j.pain.2013.07.029.PubMedCrossRefGoogle Scholar
  6. 6.
    Fox PL, Raina P, Jadad AR. Prevalence and treatment of pain in older adults in nursing homes and other long-term care institutions: a systematic review. Can Med Assoc J. 1999;160(3):329–33.Google Scholar
  7. 7.
    Schofield P. Pain in older adults: epidemiology, impact and barriers to management. Rev Pain. 2007;1(1):12–4.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Briggs AM, Cross MJ, Hoy DG, Sanchez-Riera L, Blyth FM, Woolf AD, et al. Musculoskeletal health conditions represent a global threat healthy aging: a report for the 2015 World Health Organization World Report on Ageing and Health. Gerontologist. 2016;56(2):S243–55.PubMedCrossRefGoogle Scholar
  9. 9.
    Nosraty L, Jylha M, Raittila T, Lumme-Sandt K. Perceptions by the oldest old of a successful aging. Vitality 90+ study. J Aging Stud. 2015;32:50–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Farrell MJ. Age-related changes in the structure and function of brain regions involved in pain processing. Pain Med. 2012;13(2):S37–43.PubMedCrossRefGoogle Scholar
  11. 11.
    Oosterman JM, van Harten B, Weinstein HC, Scheltens P, Scherder EJ. Pain intensity and pain affect in relation to white matter changes. Pain. 2006;125(1–2):74–81.CrossRefGoogle Scholar
  12. 12.
    Zimmerman ME, Pan JW, Hetherington HP, Lipto ML, Baigi K, Lipton RB. Hippocampal correlates of pain in healthy elderly adults: a pilot study. Neurology. 2009;73(19):1567–70.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Weiner DK, Herr K. Comprehensive interdisciplinary assessment and treatment planning: an integrative overview. In: Winer DK, Herr K, Rudy TE, editors. Persistent pain in older adults: an interdisciplinary guide for treatment. Springer: New York; 2002.Google Scholar
  14. 14.
    Solano JP, Gomes B, Higginson IJ. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease, and renal disease. J Pain Symptom Manage. 2006;31:58–69.PubMedCrossRefGoogle Scholar
  15. 15.
    Smith AK, Cenzer IS, Knight SJ, Puntillo KA, Widera E, Williams BA, et al. The epidemiology of pain in the last 2 years of life. Ann Intern Med. 2010;153:563–9.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Wylde V, Hewlett S, Learmonth ID, et al. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain. 2011;152:457–76.CrossRefGoogle Scholar
  17. 17.
    Helme RD, Gibson SJ. The epidemiology of pain in elderly people. Clin Geriatr Med. 2001;17(3):4517–431.CrossRefGoogle Scholar
  18. 18.
    Melzer D, Gardener E, Guralnik JM. Mobility disability in the middle-aged: cross-sectional associations in the English Longitudinal Study of Ageing. Age Ageing. 2005;34(6):594–602.PubMedCrossRefGoogle Scholar
  19. 19.
    Blomqvist K, Edberg A. Living with persistent pain: experiences of older people receiving home care. J Adv Nurs. 2002;40(3):297–306.PubMedCrossRefGoogle Scholar
  20. 20.
    Reyes-Gibby CC, Aday L, Cleeland C. Impact of pain on self-rated health in the community-dwelling older adults. Pain. 2002;95(1–2):75–82.PubMedCrossRefGoogle Scholar
  21. 21.
    Stubbs B, Bimmekade TT, Soundy A, Schofield P, Huijnen IP, Eggermont LH. Are older adults with chronic musculoskeletal pain less active than older adults without pain? A systematic review and meta-analysis. Pain Med. 2013;14:1316–31.PubMedCrossRefGoogle Scholar
  22. 22.
    Lihavainen K, Sipila S, Rantanen T, Sihvonen S, Sulkava R, Hartikainen S. Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2010;65:990–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Karttunen N, Lihavainen K, Sipila S, Rantanen T, Sulkava R, Hartikainen S. Musculoskeletal pain and use of analgesics in relation to mobility limitation among community-dwelling persons aged 75 years and older. Eur J Pain. 2012;16:140–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Eggermont LH, Bean JF, Guralnik JM, Leveille SG. Comparing pain severity versus pain location in the MOBILIZE Boston study: chronic pain and lower extremity function. J Gerontol A Biol Sci Med Sci. 2009;64:763–70.PubMedCrossRefGoogle Scholar
  25. 25.
    Weiner DK, Haggerty CL, Krichevsky SO, Harris T, Simosick EM, Nevitt M, et al. How does low back pain impact physical function in independent, well-functioning older adults? Evidence from Health ABC cohort and implications for the future. Pain Med. 2003;4:311–20.PubMedCrossRefGoogle Scholar
  26. 26.
    Reid KJ, Harker J, Bala MM, Truyers C, Kellen E, Bekkering GE, et al. Epidemiology of chronic non-cancer pain in Europe: narrative review of pain prevalence, pain treatment and pain impact. Curr Med Res Opin. 2011;27:449–62.PubMedCrossRefGoogle Scholar
  27. 27.
    Leadley RM, Armstrong N, Reid KJ, Allen A, Misso KV, Kleijnen J. Healthy aging in relation to chronic pain and quality of life in Europe. Pain Pract. 2013;14(6):547–58.PubMedCrossRefGoogle Scholar
  28. 28.
    Leveille SG, Fried L, Guralnik JM. Disabling symptoms: what do older women report? J Gen Intern Med. 2002;17(10):766–73.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Karp JF, Shega JW, Morone NE, Weiner DK. Advances in understanding the mechanisms and the management of persistent pain in older adults: the critical role of descending inhibition. Br J Anaesth. 2008;101:111–20.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Blyth FM, Rochat S, Cumming RG, Creasey H, Handelsman DJ, Le Couteur DG, et al. Pain, frailty and comorbidity on older men: the CHAMP study. Pain. 2008;140:224–30.PubMedCrossRefGoogle Scholar
  31. 31.
    Wade KF, Marshall A, Vanhoutte B, et al. Does pain predict frailty in older men and women? Findings from the English Longitudinal Study of Ageing (ELSA). J Gerontol A Biol Sci Med Sci. 2017;72(3):403–9.PubMedGoogle Scholar
  32. 32.
    Hassett AL, Epel E, Clauw DJ, Harris RE, Harte SE, Kairys A, et al. Pain is associated with short leukocyte telomere length in women with fibromyalgia. J Pain. 2012;13(10):959–69.PubMedCrossRefGoogle Scholar
  33. 33.
    Cruz-Almeyda Y, Aguirre M, Sorenson HL, Tighe P, Wallet SM, Riley JL. Age differences in cytokine expression under conditions of health using experimental pain models. Exp Gerontol. 2015;72:150–6.CrossRefGoogle Scholar
  34. 34.
    Krebs EE, Carey TS, Weinberger M. Accuracy of the pain numeric rating scale as a screening test in primary care. J Gen Intern Med. 2007;22(10):1453–8.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Scher C, Meador L, Van Cleave JH, Reid MC. Moving beyond pain as the fifth vital sign and patient satisfaction scores to improve pain care in the 21st century. Pain Manag Nurs. 2018;19(2):125–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Reid MC. Expanding targets for intervention in later life pain: what role can patient beliefs, expectations and pleasant activities play. Clin Geriatr Med. 2016;32(4):797–805.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Keller S, Bann C, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use documenting the outcomes of patients with non-cancer pain. Clin J Pain. 2004;5:309–18.CrossRefGoogle Scholar
  38. 38.
    Blozik E, Stuck AE, Niemann S, Ferrell BA, Harari D, von Renteln-Kruse W, et al. Geriatric pain measure short form: development and initial evaluation. J Am Geriatr Soc. 2007;55(12):2045–50.PubMedCrossRefGoogle Scholar
  39. 39.
    Krebs EE, Lorenz KA, Bair MJ, Damush TM, Wu J, Sutherland JM, et al. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009;24(6):733–8.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
  41. 41.
    Herr K, Coyne PJ, McCaffery M, Manworren R, Merkel S. Pain assessment in the patient unable to self-report: position statement with clinical practice recommendations. Pain Manag Nurs. 2011;12:230–50.PubMedCrossRefGoogle Scholar
  42. 42.
    American Geriatrics Society Panel on Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57:1331–46.CrossRefGoogle Scholar
  43. 43.
    Reid MC, Eccleston C, Pillemer K. Chronic pain in older adults. BMJ. 2015;350:h532.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Larsson C, Hansson EE, Sundquist K, Jakobsson U. Chronic pain in older adults: prevalence, incidence and risk factors. Scand J Rheumatol. 2017;46(4):317–25.PubMedCrossRefGoogle Scholar
  45. 45.
  46. 46.
    Runhaar J, de Vos BC, van Middelkoop M, Vroegindweij D, Oei EH, Bierma-Zienstra SM. Prevention of incident knee osteoarthritis by moderate weight loss in overweight and obese females. Arthritis Care Res. 2016;68(10):1428–33.CrossRefGoogle Scholar
  47. 47.
  48. 48.
    Paolucci T, Saraceni VM, Piccinini G. Management of chronic pain in osteoporosis: challenges and solutions. J Pain Res. 2016;9:177–86.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Kling JM, Clarke BL, Sandhu NP. Osteoporosis prevention, screening and treatment: a review. J Womens Health. 2014;23(7):563–72.CrossRefGoogle Scholar
  50. 50.
    Hartvigsen J, Christensen K. Active lifestyle protects against incident low back pain in seniors. A population-based 2-year prospective study of 1387 Danish twins aged 70-100 years. Spine. 2007;31(1):76–81.CrossRefGoogle Scholar
  51. 51.
    Quicke JG, Foster NE, Ogollah RO, Croft PR, Holden MA. Relationship between attitudes and beliefs and physical activity in older adults with knee pain: secondary analysis of a randomized controlled trial. Arthritis Care Res. 2017;69(8):1192–200.CrossRefGoogle Scholar
  52. 52.
  53. 53.
    Dowell D, Haegerick TM, Chou R. CDC guideline for prescribing opioids for chronic pain-United States, 2016. JAMA. 2016;315(15):1624–45.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
  55. 55.
    Chou R, Deyo R, Friedly J, et al. Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline. Ann Intern Med. 2017;166:493–505.PubMedCrossRefGoogle Scholar
  56. 56.
    Penninx BW, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, et al. Physical exercise and the prevention of disability in activity of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161(19):2309–16.PubMedCrossRefGoogle Scholar
  57. 57.
    Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ. Weight loss reduces the risk for symptomatic knee osteoarthritis in women: the Framingham study. Ann Intern Med. 1992;1116(7):535–9.CrossRefGoogle Scholar
  58. 58.
    Cheung C, Wyman JF, Bronas U, McCarthy T, Rudser K, Mathiason MA. Managing knee osteoarthritis with yoga or aerobic/strengthening exercise programs in older adults: a pilot randomized controlled trial. Rheumatol Int. 2017;37(3):389–98.PubMedCrossRefGoogle Scholar
  59. 59.
    Kong LJ, Lauche R, Klose P, Bu JH, Yang XC, Guo CQ, et al. Tai chi for chronic pain conditions: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2016;6:25325.  https://doi.org/10.1038/srep25325.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Park J, McCaffrey R, Newman D, Liehr P, Ouslander JG. A pilot randomized controlled trial of the effects of chair yoga on pain and physical function among community-dwelling older adults with lower extremity osteoarthritis. J Am Geriatr Soc. 2017;65(3):592–7.PubMedCrossRefGoogle Scholar
  61. 61.
    Lunde LH, Nordhus IH, Pallesen S. The effectiveness of cognitive and behavioural treatment of chronic pain in the elderly: a quantitative review. J Clin Psychol Med Settings. 2009;16(3):254–62.PubMedCrossRefGoogle Scholar
  62. 62.
    Morone NE, Greco CM, Moore CG, et al. A mind-body program for older adults with chronic low back pain: a randomized controlled trial. JAMA Intern Med. 2016;176(3):329–37.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Rini C, Williams DA, Broderick JE, Keefe FJ. Meeting them where they are: using the internet to deliver behavioral medicine interventions for pain. Transl Behav Med. 2012;2(1):82–92.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Reynoldson C, Stones C, Allsop M, et al. Assessing the quality and usability of smartphone apps for pain self-management. Pain Med. 2014;15(6):898–909.PubMedCrossRefGoogle Scholar
  65. 65.
    Towheed TE, Maxwell L, Judd MG, Catton M, Hochberg MC, Wells G. Acetaminophen for osteoarthritis. Cochrane Database Syst Rev. 2006;1:CD004257.Google Scholar
  66. 66.
    Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514–30.PubMedCrossRefGoogle Scholar
  67. 67.
    Papaleontiou M, Henderson CR, Turner BJ, Moore AA, Olkhovskaya Y, Amanfo L, et al. Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2010;58(7):1353–69.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health pathway to prevention workshop. Ann Intern Med. 2015;162(4):276–86.  https://doi.org/10.7326/M14-2559.PubMedCrossRefGoogle Scholar
  69. 69.
  70. 70.
    Makris UA, Abrams RC, Gurland B, Reid MC. Management of persistent pain in the older patient: a clinical review. JAMA. 2014;312(8):825–36.PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Pickering G, Marcoux M, Chapiro S, et al. An algorithm for neuropathic pain management in older people. Drugs Aging. 2016;33(8):575–83.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Nugent SM, Morasco BJ, O’Neil ME, et al. The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med. 2017;167(5):319–31.PubMedCrossRefGoogle Scholar
  73. 73.
    Derry S, Wiffen PJ, Moore R, Quinlan J. Topical lidocaine for neuropathic pain in adults. Cochrane Database Syst Rev. 2014;(7):CD010958.Google Scholar
  74. 74.
    Guerriero F, Bolier R, Van Cleave JH, Reid MC. Pharmacological approaches for the management of persistent pain in older adults: what nurses need to know. J Gerontol Nurs. 2016;42(12):49–57.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Fabio Guerriero
    • 1
  • M. Carrington Reid
    • 2
  1. 1.Department of Internal Medicine and Medical TherapyUniversity of PaviaPaviaItaly
  2. 2.Department of MedicineWeill Cornell MedicineNew YorkUSA

Personalised recommendations