Epidemiology of Pain in Older People

  • Gisèle PickeringEmail author
Part of the Perspectives in Nursing Management and Care for Older Adults book series (PNMCOA)


In both developed and developing countries, populations are aging, largely due to a significant increase in life expectancy. This phenomenon will continue to progress over the next few decades. Chronic pain is the most frequently reported symptom in community settings, where most older people liven, as well as in residential care units. Pain is accompanied by heterogeneous comorbidities and dramatically impairs the quality of life of older people. Pain management is particularly difficult in older people with communication disorders, and this public health problem remains overall underrecognized and undertreated.


Epidemiology Prevalence Atypical pain Depression Dementia 


  1. 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(Suppl 1):i1–57.CrossRefPubMedGoogle Scholar
  2. Abeare CA, Cohen JL, Axelrod BN, Leisen JC, Mosley-Williams A, Lumley MA. Pain, executive functioning, and affect in patients with rheumatoid arthritis. Clin J Pain. 2010;26(8):683–9.PubMedPubMedCentralGoogle Scholar
  3. Achterberg WP, Gambass GI, Finne-Soveri H, Liperoti R, Noro A, et al. Pain in European long-term care facilities: cross-National Study in Finland, Italy and The Netherlands. Pain. 2010;148:70–4.CrossRefPubMedGoogle Scholar
  4. American Geriatrics Society [AGS] Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc. 2002;50(Suppl 6):S205–24.Google Scholar
  5. Baker KS, Gibson SJ, Georgiou-Karistianis N, Giummarra MJ. Relationship between self-reported cognitive difficulties, objective neuropsychological test performance and psychological distress in chronic pain. Eur J Pain. 2017;21:601–13.Google Scholar
  6. Banks SM, Kerns RD. Explaining high rates of depression in chronic pain: a diathesis-stress framework. Psychol Bull. 1996;119:95–110.CrossRefGoogle Scholar
  7. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333.CrossRefPubMedGoogle Scholar
  8. de Tommaso M, Arendt-Nielsen L, Defrin R, Kunz M, Pickering G, Valeriani M. Pain assessment in neurodegenerative diseases. Behav Neurol. 2016;2016:2949358.PubMedPubMedCentralGoogle Scholar
  9. Eccleston C, editor. Pickering pain and geriatrics in Europe in European pain management. Oxford: Oxford University Press; 2017.Google Scholar
  10. Eritz H, Hadjistavropoulos T. Do informal caregivers consider nonverbal behavior when they assess pain in people with severe dementia? J Pain. 2011;12:331–9.CrossRefPubMedGoogle Scholar
  11. French HP, Smart KM, Doyle F. Prevalence of neuropathic pain in knee or hip osteoarthritis: a systematic review and meta-analysis. Semin Arthritis Rheum. 2017;47(1):1–8.CrossRefPubMedGoogle Scholar
  12. Gibson SJ. Age differences in psychological factors related to pain perception and report. In: Gibson SJ, Wiener DK, editors. Pain in older adults. Seattle: IASP Press; 2005. p. 87–110.Google Scholar
  13. Gibson SJ, Lussier D. Prevalence and relevance of pain in older persons. Pain Med. 2012;13:S23–6.CrossRefPubMedGoogle Scholar
  14. Husebo BS, Ballard C, Sandvik R, Nilsen OB, Aarsland D. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. BMJ. 2011;343:d4065.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Hwang SY, Park EH, Shin ES, Jeong MH. Comparison of factors associated with atypical symptoms in younger and older patients with acute coronary syndromes. J Korean Med Sci. 2009;24(5):789–94.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Jensen-Dahm C, Vogel A, Waldorff FB, Waldemar G. Discrepancy between self- and proxy-rated pain in Alzheimer’s disease: results from the Danish Alzheimer Intervention Study. J Am Geriatr Soc. 2012;60:1274–8.CrossRefPubMedGoogle Scholar
  17. Kenefick AL. Pain treatment and quality of life: reducing depression and improving cognitive impairment. J Gerontol Nurs. 2004;30:22–9.CrossRefPubMedGoogle Scholar
  18. Lee DM, Pendleton N, Tajar A, O'Neill TW, O'Connor DB, Bartfai G, et al. Chronic widespread pain is associated with slower cognitive processing speed in middle-aged and older European men. Pain. 2010;151(1):30–6.CrossRefPubMedGoogle Scholar
  19. Macintyre PE, Schug SA. Acute pain management: a practical guide. 3rd ed. Saunders Elsevier: Edinburgh; 2007.Google Scholar
  20. Miranda VS, Decarvalho VB, Machado LA, Dias JM. Prevalence of chronic musculoskeletal disorders in elderly Brazilians: a systematic review of the literature. BMC Musculoskelet Disord. 2012;13:82.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Pelletier IC, Landreville P. Discomfort and agitation in older adults with dementia. BMC Geriatr. 2007;7:27.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Pickering G. In: Gibson S, Lautenbacher S, editors. “Pharmacological treatment”, chapter in “pain and dementia”. Washington, DC: IASP Press; 2016.Google Scholar
  23. Pickering G, Herpes Zoster and Functional Decline Consortium. Functional decline and herpes zoster in older people: an interplay of multiple factors. Aging Clin Exp Res. 2015;27(6):757–65.CrossRefGoogle Scholar
  24. Pickering G, Leplege A. Herpes zoster, postherpetic neuralgia and quality of life. Pain Pract. 2011;11:397–402.CrossRefPubMedGoogle Scholar
  25. Pickering G, Deteix A, Eschalier A, Dubray C. Impact of pain of nursing home residents on their recreational activities. Aging. 2001;13:44–8.PubMedGoogle Scholar
  26. 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(8):575–83.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Rapo-Pylkkö S, et al. Neuropathic pain among community-dwelling older people: a clinical study in Finland. Drugs Aging. 2015;32:737–42.CrossRefPubMedGoogle Scholar
  28. Roberts R, Knopman DS. Classification and epidemiology of MCI. Clin Geriatr Med. 2013;29(4):753–72.CrossRefPubMedGoogle Scholar
  29. Savvas S, Gibson S. Pain management in residential aged care facilities. Aust Fam Physician. 2015;44(4):198–203.PubMedGoogle Scholar
  30. Sengstaken EA, King SA. The problems of pain and its detection among geriatric nursing home residents. J Am Geriatr Soc. 1993;41:541–4.CrossRefPubMedGoogle Scholar
  31. Small GW, Rabins PV, Barry PP, et al. Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer’s Association, and the American Geriatrics Society. JAMA. 1997;278:1363–71.CrossRefPubMedGoogle Scholar
  32. Smith BH, Elliott AM, Chambers WA, Smith WC, Hannaford PC, Penny K. The impact of chronic pain in the community. Fam Pract. 2001;18(3):292–9.CrossRefPubMedGoogle Scholar
  33. Takai Y, Yamamoto-Mitani N, Okamoto Y, Koyama K, Honda A. Literature review of pain prevalence among older residents of nursing homes. Pain Manag Nurs. 2010;11(4):209–23.CrossRefPubMedGoogle Scholar
  34. Teno JM, Kabumoto G, Wetle T, Roy J, Mor V. Daily pain that was excruciating at some time in the previous week: prevalence, characteristics, and outcomes in nursing home residents. J Am Geriatr Soc. 2004;52(5):762–7.CrossRefPubMedGoogle Scholar
  35. UNDESA. Population division, World population prospects: the 2015 revision, DVD Edition; 2015.Google Scholar
  36. van Herk R, van Dijk M, Biemold N, Tibboel D, Baar FPM, de Wit R. Assessment of pain: can caregivers or relatives rate pain in nursing home residents? J Clin Nurs. 2009;18:2478–85.CrossRefPubMedGoogle Scholar
  37. van Kooten J, Binnekade TT, van der Wouden JC, Stek ML, Scherder EJ, Husebø BS, Smalbrugge M, Hertogh CM. A review of pain prevalence in Alzheimer’s, vascular, frontotemporal and Lewy body dementias. Dement Geriatr Cogn Disord. 2016;41(3-4):220–32.CrossRefPubMedGoogle Scholar
  38. Weiner DK, Rudy TE, Morrow L, Slaboda J, Lieber S. The relationship between pain, neuropsychological performance and physical function in community-dwelling older adults with chronic low back pain. Pain Med. 2006;7:60–70.CrossRefPubMedGoogle Scholar
  39. Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety. 2010;27(2):190–211.CrossRefPubMedGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical PharmacologyUniversity Regional HospitalClermont-FerrandFrance
  2. 2.Inserm CIC 1405 and Neurodol 1107Medical FacultyClermont-Ferrand, CedexFrance

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