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Introduction: Emergency department (ED) stay and its associated conditions (immobility, inadequate hydration and nutrition, lack of stimulation) favor the development of delirium in vulnerable elderly patients. Poorly controlled pain, and paradoxically opioid pain treatment, has also been identified as a trigger for delirium. The aim of this study was to assess the relationship between pain, opioid treatment, and delirium in elderly ED patients. Methods: A multicenter prospective cohort study was conducted in four hospitals across the province of Québec (Canada). Patients aged 65 years old, waiting for care unit admission between February and May 2016, who were non-delirious upon ED [...]

Abstract AIM: The present cross-sectional study investigated the relationship between frailty and chronic pain, activities of daily living (ADL), and physical activity in community-dwelling older adults. METHODS: Participants were 379 older adults who attended community-based exercise classes. Outcome measures were frailty as determined by the Kihon Checklist, full pain assessment (including the sensory, emotional and cognitive aspects of pain), ADL and physical activity. These outcomes were evaluated using validated tests and instruments. Assessments were carried out before beginning the exercise classes. Outcome measures were compared for participants with and without frailty. Frailty was defined as a total Kihon Checklist score [...]

Abstract Pain significantly restricts the quality of life and well-being of older adults. With our increasingly ageing population, it is important to examine whether differing classes of biopsychosocial risk factors can predict the development of pain in older adults. Latent class analysis (LCA) provides a model-based approach to identifying underlying subgroups in a population, based on some measured characteristics. In this study, LCA was used to identify biopsychosocial risk classes in people aged over 50, from The Irish Longitudinal Study on Aging (TILDA), who reported not often being troubled by pain at Wave 1 and completed the two year follow-up [...]

Authors:  ©Jason Fanning, Amber K Brooks, Edward Ip, Barbara J Nicklas, W Jack Rejeski. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.05.2018. BACKGROUND: Chronic pain is a complex, age-related health issue that affects both physical functioning and quality of life. Because the impact of chronic pain is worsened by obesity and inactivity, nonpharmacological interventions that promote movement, reduce sitting, and aid in weight loss are needed to help manage pain symptoms among older adults with chronic pain. OBJECTIVE: The Mobile Intervention to Reduce Pain and Improve Health (MORPH) pilot trial aims to develop and test the feasibility and acceptability of [...]

After a hospitalization, age is positively associated with the likelihood of receiving an opioid prescription and patients that are older than 76 years of age have the greatest odds of continued opioid exposure, according to a new study. Additionally, the findings showed that 20% of older adults that were given a new opioid prescription after hospitalization received at least 1 more within 3 to 9 months, and 4.8% met the criteria for long-term use. To read the full article by Matt Hoffman click here.

Association Between Psychological Interventions and Chronic Pain Outcomes in Older Adults: A Systematic Review and Meta-analysis Bahar Niknejad, MD, Ruth Bolier, MD, PhD, Charles R. Henderson Jr, Diana Delgado, MLS, Elissa Kozlov, PhD, Corinna E. Löckenhoff, PhD, M. Carrington Reid, MD, PhD Key Points Question  Do older adults with chronic pain benefit from psychological therapies? Findings  In this systematic review and meta-analysis including 22 studies with 2608 participants, psychological interventions that used cognitive behavioral therapy modalities were associated with statistically significant benefits in terms of reduced pain and catastrophizing beliefs as well as improved self-efficacy for managing pain. Benefits were small and documented at the time of treatment completion; with the exception of pain reduction, evidence is lacking for the persistence [...]

Question:  For patients with moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use, does opioid medication compared with nonopioid medication result in better pain-related function? Findings:  In this randomized clinical trial that included 240 patients, the use of opioid vs nonopioid medication therapy did not result in significantly better pain-related function over 12 months (3.4 vs 3.3 points on an 11-point scale at 12 months, respectively). Meaning:  This study does not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain. Click here to read the [...]

This study aimed to screen the prevalence of pain in Chinese community- dwelling older adults and to evaluate the effects of a brief mindfulness- based intervention on chronic pain. The prevalence of pain among Chinese older adults was 40.5%. The brief mindfulness intervention had significant effects on reducing pain intensity (P = 0.004), and increasing the mind- fulness measures: observing, acting with awareness, non-judging and non- reactivity inner experience (all P values < 0.05). Pain prevalence among Chinese older adults was relatively high. This study showed that a brief mindfulness-based intervention reduced ratings of pain intensity and enhanced ratings of [...]

Health care professionals who specialize in treating chronic pain have moved beyond what doctors call a unidimensional evaluation to a multidimensional one.  It makes total sense, says  Cary Reid, MD, PhD, director of the Translational Research Institute on Pain in Later Life at Weill Cornell Medical Center, New York. “Pain is something that has many dimensions,” he says. “One thing important is the severity level.” So using what the doctors call the numeric rating scale or NRS, the zero to 10 question, is fine as a start. After that, many more questions should follow, Dr. Reid says. “What we want [...]

Age is one of the most critical factors associated with chronic pain. Compared to their younger counterparts, older adults suffer more from CLBP, seek less care (Knauer, Freburger, & Carey, 2010), and are more susceptible to poor pain outcomes, including disability and mortality (Gagliese, 2009). Older adults face numerous barriers in accessing chronic pain care, such as poor communication with health care providers, transportation problems, and psychosocial limitations (Park, Hirz, Manotas, & Hooyman, 2013). It is established that older adults often fail to receive adequate chronic pain treatment (e.g., Chodosh et al., 2004; McNeill, Sherwood, & Starck, 2004). Harkins (2005) [...]