Health risk appraisal in older people 3: prevalence, impact, and context of pain and their implications for GPs

Br J Gen Pract. 2007 Aug;57(541):630-5.

Abstract

Background: Pain is a common experience in later life. There is conflicting evidence of the prevalence, impact, and context of pain in older people. GPs are criticised for underestimating and under-treating pain.

Aim: To assess the extent to which older people experience pain, and to explore relationships between self-reported pain and functional ability and depression.

Design of study: Secondary analysis of baseline data from a randomised controlled trial of health risk appraisal.

Setting: A total of 1090 community-dwelling non-disabled people aged 65 years and over were included in the study from three group practices in suburban London.

Method: Main outcome measures were pain in the last 4 weeks and the impact of pain, measured using the 24-item Geriatric Pain Measure; depression symptoms captured using the 5-item Mental Health Inventory; social relationships measured using the 6-item Lubben Social Network Scale; Basic and Instrumental Activities of Daily Living and self-reported symptoms.

Results: Forty-five per cent of women and 34% of men reported pain in the previous 4 weeks. Pain experience appeared to be less in the 'oldest old': 27.5% of those aged 85 years and over reported pain compared with 38-53% of the 'younger old'. Those with arthritis were four times more likely to report pain. Pain had a profound impact on activities of daily living, but most of those reporting pain described their health as good or excellent. Although there was a significant association between the experience of pain and depressed mood, the majority of those reporting pain did not have depressed mood.

Conclusion: A multidimensional approach to assessing pain is appropriate. Primary care practitioners should also assess the impact of pain on activities of daily living.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cross-Sectional Studies
  • Depressive Disorder / etiology*
  • Family Practice*
  • Female
  • Geriatric Assessment
  • Health Status
  • Health Status Indicators*
  • Humans
  • London / epidemiology
  • Male
  • Pain / complications
  • Pain / epidemiology*
  • Pain / psychology
  • Pain Measurement
  • Prevalence
  • Quality of Life*
  • Regression Analysis