Case of the Month #42: Persistent Pain in Older Adults by Dr Sonia Pierce

This section poses several questions that you may wish to consider to develop your knowledge of the topic of Pain in Older Adults. Each question is followed by a reference to at least one open access paper containing relevant information. Other papers in the ‘Recommended Reading’ section for September 2024 will also give further insights.

How common is pain is older adults and what are the mechanisms of persistent pain in the elderly?

• Dagnino APA, Campos MM. Chronic Pain in the Elderly: Mechanisms and Perspectives. Front Hum Neurosci. 2022 Mar 3;16:736688. doi: 10.3389/fnhum.2022.736688.
• Mullins S, Hosseini F, Gibson W, Thake M. Physiological changes from ageing regarding pain perception and its impact on pain management for older adults. Clin Med (Lond). 2022 Jul;22(4):307-310. doi: 10.7861/clinmed.22.4.phys.

What are the biopsychosocial factors that may influence the chronic pain experience of older adults?

• Miaskowski C, Blyth F, Nicosia F, Haan M, Keefe F, Smith A, Ritchie C. A Biopsychosocial Model of Chronic Pain for Older Adults. Pain Med. 2020 Sep 1;21(9):1793-1805. doi: 10.1093/pm/pnz329.

What is the impact of persistent pain on the physical function and wellbeing of older adults?

• Ritchie CS, Patel K, Boscardin J, Miaskowski C, Vranceanu AM, Whitlock E, Smith A. Impact of persistent pain on function, cognition, and well-being of older adults. J Am Geriatr Soc. 2023 Jan;71(1):26-35. doi: 10.1111/jgs.18125.

What is the impact of multisite pain on cognition?

• Zhao W, Zhao L, Chang X, Lu X, Tu Y. Elevated dementia risk, cognitive decline, and hippocampal atrophy in multisite chronic pain. Proc Natl Acad Sci U S A. 2023 Feb 28;120(9):e2215192120. doi: 10.1073/pnas.2215192120.

What are the benefits of Tai Chi in pain management approaches for older adults?

• You T, Leveille SG, Yeh GY, Wayne PM. Is Tai Chi beneficial for multisite pain syndrome in older adults? Aging Clin Exp Res. 2023 Jul;35(7):1443-1448. doi: 10.1007/s40520-023-02439-2.

What is frailty and how are pain and frailty linked?

• Guerriero F, Reid MC. Linking Persistent Pain and Frailty in Older Adults. Pain Med. 2020 Jan 1;21(1):61-66. doi: 10.1093/pm/pnz174.

What is the relationship between pain, cognition, and analgesic use in older adults?

• Warner NS, Mielke MM, Verdoorn BP, Knopman DS, Hooten WM, Habermann EB, Warner DO. Pain, Opioid Analgesics, and Cognition: A Conceptual Framework in Older Adults. Pain Med. 2023 Feb 1;24(2):171-181. doi: 10.1093/pm/pnac113.

How can pain in individuals with advanced dementia be assessed?

• Felton N, Lewis JS, Cockburn SJ, Hodgson M, Dawson S. Pain Assessment for Individuals with Advanced Dementia in Care Homes: A Systematic Review. Geriatrics (Basel). 2021 Oct 19;6(4):101. doi: 10.3390/geriatrics6040101.

Are pain management programmes and psychological therapies for older people living with pain beneficial?

• Lam N, Green J, Hallas S, Forster A, Crocker TF, Andre D, Ellwood A, Clegg A, Brown L. Mapping review of pain management programmes and psychological therapies for community-dwelling older people living with pain. Eur Geriatr Med. 2024 Feb;15(1):33-45. doi: 10.1007/s41999-023-00871-1.

Does pain influence falls risks in older adults?

• Ogliari G, Ryg J, Andersen-Ranberg K, Scheel-Hincke LL, Collins JT, Cowley A, Di Lorito C, Howe L, Robinson KR, Booth V, Walsh DA, Gladman JRF, Harwood RH, Masud T. Association of pain and risk of falls in community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Geriatr Med. 2022 Dec;13(6):1441-1454. doi: 10.1007/s41999-022-00699-1.

What social factors can influence pain experience and how do these impact upon mood?

• Powell VD, Kumar N, Galecki AT, Kabeto M, Clauw DJ, Williams DA, Hassett A, Silveira MJ. Bad company: Loneliness longitudinally predicts the symptom cluster of pain, fatigue, and depression in older adults. J Am Geriatr Soc. 2022 Aug;70(8):2225-2234. doi: 10.1111/jgs.17796.

Does physical activity influence musculoskeletal pain in older adults?

• Niederstrasser NG, Attridge N. Associations between pain and physical activity among older adults. PLoS One. 2022 Jan 28;17(1):e0263356. doi: 10.1371/journal.pone.0263356.

 

Can physical therapy improve musculoskeletal pain in older adults?

• Pacheco-da-Costa S, Soto-Vidal C, Calvo-Fuente V, Yuste-Sánchez MJ, Sánchez-Sánchez B, Asúnsolo-Del-Barco Á. Evaluation of Physical Therapy Interventions for Improving Musculoskeletal Pain and Quality of Life in Older Adults. Int J Environ Res Public Health. 2022 Jun 8;19(12):7038. doi: 10.3390/ijerph19127038.

For details on current management approaches and further reading, please see the references below and the “Recommending Reading ” section of FPMLearning.