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Aging Clinical and Experimental Research

, Volume 28, Issue 2, pp 347–353 | Cite as

Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level

  • César Gálvez-BarrónEmail author
  • Leire Narvaiza
  • María D. Dapena
  • Oscar Macho
  • Alejandro Rodríguez-Molinero
Original Article

Abstract

Background

In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population.

Aims

To explore prevalence and considered pharmacological treatments for pain in this population.

Methods

Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews.

Results

Pain’s prevalence was 52.5 % (CI 95 % 48.28–56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93–1.02) in females and 0.99 (CI 95 % 0.92–1.06) in males].

Conclusions

The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline’s recommendations are probably not being considered to select the analgesic therapy.

Keywords

Pain Analgesics use Aged 80 and over Epidemiology 

Notes

Acknowledgments

We thank Dr. Antonio Yuste Marco for the hard work done in research management and administration. We thank Natalia Gonzalo and Esther Valldosera for their invaluable work in data collection and quality control during the field work. The present work has been supported by the project CAALYX (IST-2005-045215) funded by the European Commission within the 6th Framework Programme, and the Spanish Geriatric and Gerontology Society. These organizations did not participate in the design, data analysis and interpretation, or any other relevant issue of this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study was approved by the reference Ethics Committee of the research centre where the study was conducted and written informed consent was obtained from all participants. In case, a cognitively incapacitated potential participant was contacted, the proxy or a legally authorized relative was asked to participate in the trial.

References

  1. 1.
    Stein WM, Ferrell BA (1996) Pain in the nursing home. Clin Geriatr Med 12:601–613PubMedGoogle Scholar
  2. 2.
    Won A, Lapane K, Gambassi G et al (1999) Correlates and management of nonmalignant pain in the nursing home. SAGE Study Group. Systematic assessment of geriatric drug use via epidemiology. J Am Geriatr Soc 47:936–942CrossRefPubMedGoogle Scholar
  3. 3.
    Patel KV, Guralnik JM, Dansie EJ et al (2013) Prevalence and impact of pain among older adults in the United States: findings from the 2011 National Health and Aging Trends Study. Pain 154:2649–2657CrossRefPubMedGoogle Scholar
  4. 4.
    Brattberg G, Parker MG, Thorslund M (1996) The prevalence of pain among the oldest old in Sweden. Pain 67:29–34CrossRefPubMedGoogle Scholar
  5. 5.
    Landi F, Russo A, Liperoti R et al (2009) Daily pain and functional decline among old-old adults living in the community: results from the ilSIRENTE Study. J Pain Symptom Manage 38:350–357CrossRefPubMedGoogle Scholar
  6. 6.
    Duncan R, Francis RM, Collerton J et al (2011) Prevalence of arthritis and joint pain in the oldest old: findings from the Newcastle 85 + study. Age Ageing 40:752–755CrossRefPubMedGoogle Scholar
  7. 7.
    Català E, Reig E, Artés M et al (2002) Prevalence of pain in the Spanish population: telephone survey in 5000 homes. Eur J Pain 6:133–140CrossRefPubMedGoogle Scholar
  8. 8.
    Miró J, Paredes S, Rull M et al (2007) Pain in older adults: a prevalence study in the Mediterranean region of Catalonia. Eur J Pain 11:83–92CrossRefPubMedGoogle Scholar
  9. 9.
    Stewart C, Leveille SG, Shmerling RH et al (2012) Management of persistent pain in older adults: the MOBILIZE Boston Study. J Am Geriatr Soc 60:2081–2086PubMedPubMedCentralGoogle Scholar
  10. 10.
    Won A, Lapane KL, Vallow S et al (2006) Long-term effects of analgesics in a population of elderly nursing home residents with persistent nonmalignant pain. J Gerontol A Biol Sci Med Sci 61:165–169CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Bieri D, Reeve RA, Champion GD et al (1990) The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain 41:139–150CrossRefPubMedGoogle Scholar
  12. 12.
    Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of adl: a standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMedGoogle Scholar
  13. 13.
    Pfeiffer E (1975) A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 23:433–441CrossRefPubMedGoogle Scholar
  14. 14.
    Martínez de la Iglesia J, Dueñas Herrero R, Onís Vilches MC et al (2001) Spanish language adaptation and validation of the Pfeiffer’s questionnaire (SPMSQ) to detect cognitive deterioration in people over 65 years of age. Med Clin (Barc). 117:129–134CrossRefPubMedGoogle Scholar
  15. 15.
    Ortega Orcos R, Salinero Fort MA, Kazemzadeh Khajoui A et al (2007) Validation of 5 and 15 items Spanish version of the geriatric depression scale in elderly subjects in primary health care setting. Rev Clin Esp 207:559–62Google Scholar
  16. 16.
    Ministerio de Sanidad, Servicios Sociales e Igualdad. Encuesta Nacional de Salud 2006. Metodología detallada. 2006. Available at: http://www.msps.es/estadEstudios/estadisticas/encuestaNacional/encuestaNac2006/metodENS2006.pdf. Acceded 2012 Sep 11
  17. 17.
    Bergh I, Steen G, Waern M et al (2003) Pain and its relation to cognitive function and depressive symptoms: a Swedish population study of 70-year-old men and women. J Pain Symptom Manage 26:903–912CrossRefPubMedGoogle Scholar
  18. 18.
    Zarit SH, Griffiths PC, Berg S (2004) Pain perceptions of the oldest old: a longitudinal study. Gerontologist 44:459–468CrossRefPubMedGoogle Scholar
  19. 19.
    Carmaciu C, Iliffe S, Kharicha K et al (2007) Health risk appraisal in older people 3: prevalence, impact, and context of pain and their implications for GPs. Br J Gen Pract 57:630–635PubMedPubMedCentralGoogle Scholar
  20. 20.
    Covinsky KE, Lindquist K, Dunlop DD et al (2009) Pain, functional limitations, and aging. J Am Geriatr Soc 57:1556–1561CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Abdulla A, Adams N, Bone M et al (2013) Guidance on the management of pain in older people. Age Ageing 42(suppl1):i1–i57PubMedGoogle Scholar
  22. 22.
    Haasum Y, Fastbom J, Fratiglioni L et al (2011) Pain treatment in elderly persons with and without dementia: a population-based study of institutionalized and home-dwelling elderly. Drugs Aging 28:283–293CrossRefPubMedGoogle Scholar
  23. 23.
    Helme RD, Gibson SJ (2001) The epidemiology of pain in elderly people. Clin Geriatr Med 17:417–431CrossRefPubMedGoogle Scholar
  24. 24.
    Donald IP, Foy C (2004) A longitudinal study of joint pain in older people. Rheumatology (Oxford) 43:1256–1260CrossRefGoogle Scholar
  25. 25.
    Grimby C, Fastbom J, Forsell Y et al (1999) Musculoskeletal pain and analgesic therapy in a very old population. Arch Gerontol Geriatr 29:29–43CrossRefPubMedGoogle Scholar
  26. 26.
    Herr KA, Mobily PR, Kohout FJ et al (1998) Evaluation of the Faces Pain Scale for use with the elderly. Clin J Pain 14:29–38CrossRefPubMedGoogle Scholar
  27. 27.
    Scherder EJA, Plooij B (2012) Assessment and management of pain, with particular emphasis on central neuropathic pain, in moderate to severe dementia. Drugs Aging 29:701–706CrossRefPubMedGoogle Scholar
  28. 28.
    Koponen MPH, Bell JS, Karttunen NM et al (2013) Analgesic use and frailty among community-dwelling older people: a population-based study. Drugs Aging 30:129–136CrossRefPubMedGoogle Scholar
  29. 29.
    Sorensen L, Stokes JA, Purdie DM et al (2004) Medication reviews in the community: results of a randomized, controlled effectiveness trial. Br J Clin Pharmacol 58:648–664CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Landi F, Onder G, Cesari M et al (2001) Pain management in frail, community-living elderly patients. Arch Intern Med 161:2721–2724CrossRefPubMedGoogle Scholar
  31. 31.
    American Geriatrics Association (2009) Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 57:1331–1346CrossRefGoogle Scholar
  32. 32.
    Sengupta M, Bercovitz A, Harris-Kojetin LD (2010) Prevalence and management of pain, by race and dementia among nursing home residents: United States, 2004. NCHS Data Brief. 30:1–8PubMedGoogle Scholar
  33. 33.
    Pergolizzi J, Böger RH, Budd K et al (2008) Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract. 8:287–313CrossRefPubMedGoogle Scholar
  34. 34.
    Yong H-H (2006) Can attitudes of stoicism and cautiousness explain observed age-related variation in levels of self-rated pain, mood disturbance and functional interference in chronic pain patients? Eur J Pain 10:399–407CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • César Gálvez-Barrón
    • 1
    • 2
    Email author
  • Leire Narvaiza
    • 2
  • María D. Dapena
    • 2
  • Oscar Macho
    • 2
  • Alejandro Rodríguez-Molinero
    • 1
    • 2
  1. 1.Clinical Research Unit, Hospital Sant Antoni AbatFundació Privada Sant Antoni AbatBarcelonaSpain
  2. 2.Geriatrics DepartmentConsorci Sanitari del GarrafBarcelonaSpain

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