Half of Senior Citizens Afflicted by Bothersome Pain
in Last Month
Pain prevalence was higher in women; older adults
with obesity, musculoskeletal conditions, and depressive symptoms; need
for public health action for elderly
Dec. 2, 2013 More than half of senior citizens in
the United States an estimated 18.7 million people have experienced
bothersome pain in the previous month, impairing their physical function
and underscoring the need for public health action on pain. Many of
those interviewed by investigators for a study published in the current
issue of PAIN reported pain in multiple areas.
The interviews, which included assessments of
cognitive and physical performance, were completed by trained survey
research staff in the homes of study participants living in the
community or in residential care facilities, such as retirement or
"Pain is common in older adults and one of the
major reasons why we start slowing down as we age," says lead
investigator Kushang V. Patel, PhD, MPH, of the Center for Pain Research
on Impact, Measurement, and Effectiveness in the Department of
Anesthesiology and Pain Medicine at the University of Washington.
The researchers gained several insights from the
Bothersome pain afflicts half of
community-dwelling seniors in the United States.
The majority of older adults with pain reported
having pain in multiple locations, such as in the back, hips, and
The percentage of people with pain did not
differ by age, even when researchers accounted for dementia and
Pain was strongly associated with decreased
physical capacity. Older adults with pain, particularly those with
pain in multiple locations, had weaker muscle strength, slower
walking speed, and poorer overall function than those without pain.
Included: economics of health care; people who
receive care and organizations that provide care; value created in terms
of objective health outcomes and perceptions of quality of care;
potential factors driving change, including consolidation of insurers
and health systems; the patient as consumer - see
U.S. spends 50 percent more of GDP on health
care, yet life expectancy growing slower here than in other countries;
much higher medical costs and worse outcomes; aging population not cause
costs - see video
The researchers analyzed data from the National
Health and Aging Trends Study (NHATS), which was designed to investigate
multiple aspects of functioning in later life and is funded by the U.S.
National Institute on Aging, part of the National Institutes of Health.
Investigators conducted in-person interviews with 7,601 adults ages
65 years and older who were enrolled in the NHATS in 2011. All were
The overall prevalence of bothersome pain in the
last month in the study group was 52.9%. Pain did not vary across age
groups, and this pattern remained unchanged when accounting for
cognitive performance, dementia, proxy responses, and residential-care
Pain prevalence was higher in women and in older
adults with obesity, musculoskeletal conditions, and depressive
symptoms. The majority (74.9%) of older adults with pain reported
multiple sites of pain.
Several measures of physical capacity, including
muscle strength and lower-extremity physical performance, were
associated with pain and multisite pain. For example, self-reported
inability to walk three blocks was 72% higher in participants with pain
than without pain. Participants with one, two, three, and four or more
sites were 41%, 57%, 81%, and 105% more likely to report inability to
walk three blocks, respectively, than older adults without pain.
"Considering that pain is often poorly managed in
the geriatric population, our findings underscore the need for public
health action, including additional epidemiologic research and the
development and translation of interventions aimed at improving pain and
function in older adults," Patel concludes.
Population aging is occurring in nearly every
country of the world. Not only are the number and proportion of older
adults increasing globally, but the older adult population itself is
getting older as well. Gains in life expectancy at older ages have
fueled the rapid growth of the oldest-old segment of the population,
although it is unclear whether improvements in functional status of
older adults have kept pace.
Since disability in late life is a major predictor
of medical and social service needs, investigating risk factors for
functional decline is a major public health priority. Today's published
study in PAIN by Patel and colleagues clearly identifies the high
burden of pain in the elderly population.
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