Abstract
Chronic pain is common in older people affecting up to 60% of older community dwelling older persons with and without dementia. There are no neurophysiological arguments that pain perception and tolerance are affected by the ageing process or cognitive impairment. Chronic pain has a significant impact on the functionality and quality of life of older people. Systematic screening with appropriate tools for the target population followed by a clinical assessment is recommended. A holistic, multidisciplinary approach through a comprehensive geriatric assessment (CGA) (see also Chapter 26) can offer meaningful support. It is possible to safely use non-pharmacological and pharmacological treatments, provided the clinician has a good knowledge of the adverse events of the treatments. In patients with advanced dementia and patients at the end of life, alternative routes of administration of analgesics should be considered.
This is a preview of subscription content, log in via an institution.
References
AGS Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc. 2002;50:S205–24.
American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57:1331–46.
Abdulla A, Adams N, Bone M, Elliott AM, Gaffin J, Jones D, Knaggs R, Martin D, Sampson L, Schofield P, British Geriatric Society. Guidance on the management of pain in older people. Age Ageing. 2013;42:i1–57.
Gibson SJ, Farrell M. A review of age differences in the neurophysiology of nociception and the perceptual experience of pain. Clin J Pain. 2004;20:227–39.
Pickering G, Marcoux M, Chapiro S, David L, Rat P, Michel M, Bertrand I, Voute M, Wary B. An algorithm for neuropathic pain management in older people. Drugs Aging. 2016;33:575–83.
Royal College of Physicians, British Geriatrics Society and British Pain Society. The assessment of pain in older people: National Guidelines. Concise guidance to good practice series, No. 8, London: RCP, 2007. https://www.rcplondon.ac.uk/guidelines-policy/pain-assessment-pain-older-people. Accessed 27 Feb 2017.
Scherder E. Pain in dementia. In: Scherder EJA, editor. Aging and dementia. Neuropsychology, motor skills and pain. Amsterdam: VU University Press; 2013. p. 169–89.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
1 Electronic Supplementary Material
ESM 1
: Chapter 21_Pocket Card (PDF 137 kb)
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Van Den Noortgate, N. (2018). Pain. In: Roller-Wirnsberger, R., Singler, K., Polidori, M. (eds) Learning Geriatric Medicine. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-61997-2_21
Download citation
DOI: https://doi.org/10.1007/978-3-319-61997-2_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-61996-5
Online ISBN: 978-3-319-61997-2
eBook Packages: MedicineMedicine (R0)