The link between pain and frailty revealed: it’s time to move towards more effective pain management in older people

Dr. Marcos Saraiva is a geriatrician from the Division of Geriatrics of University of São Paulo Medical School, Brazil. He and his co-authors recently published the paper Persistent pain is a risk factor for frailty: a systematic review and meta-analysis from prospective longitudinal studies in Age and Ageing journal.

Pain is a very common condition in older people, ranging from 40% in community-dwelling older adults to 80% in institutionalised individuals. It is known that pain, especially persistent pain (defined as a painful experience that continues for a prolonged period of time that may or may not be associated with a recognisable disease process), is associated with depression, social isolation, anxiety, insomnia, falls, higher health costs, weight loss, greater vulnerability to stressors and functional loss in older people. Continue reading

A New Holistic Approach to Pain Management in Older People

Nan Ma is specialist registrar in clinical Gerontology and Aza Abdulla is a consultant geriatrician and general physician at the Princess Royal University Hospital, Kings College NHS Foundation Trust. He is co-founder of the Special Interest Group on Pain in Older People in the British Geriatrics Society (BGS) and participated in producing the first National Guidelines on Management of Pain in Older People. He is also the immediate past president of the Geriatrics & Gerontology Section at the Royal Society of Medicine.

painPain in older people is under-reported and often poorly appreciated. For many, it is seen as part of normal ageing and has to be accepted. It is also a subjective feeling (different people have different pain thresholds) making it difficult for the clinician to quantify its impact in an individual patient. Consequently, it may be overlooked as an important factor that can affect older people’s wellbeing. In fact, chronic pain has a huge influence on quality of life (QoL) through its effects on the physical and mental state, which in turn adversely impacts on the older individual’s economic and social status (effects on carers, friends and family). Inadequately controlled pain perpetuates disability, anxiety, and depression all interfering with the overall QoL. It follows that effective management of pain is crucial in optimising welfare in the older person. Continue reading

Chronic disease begins in childhood

A conference report from the BGS Spring Meeting in Belfast, by Liz Gill.

Research is increasingly suggesting that old age is influenced by conditions and events in early life, a concept supported by data from The Irish Longitudinal Study on Ageing, TILDA, which has studied 8,500 people aged 50 and over for the past ten years. Opening a special session on the last morning of the conference, its principal investigator Prof Rose-Anne Kenny of Trinity College Dublin, described the process. Participants were given an initial comprehensive assessment which included physical health, cognition, psychology, behaviour, family background and use of health care. They were then revisited every two years providing a rich set of data involving almost one in every 140 people in Ireland. Continue reading