Image of senior woman receiving physical therapy from therapist on exercise mat

Persistent pain is common in older adults and is estimated to affect up to 58% of nursing home residents. It also contributes to significant declines in physical function and well-being in seniors, researchers say.

In a new study, investigators from Harvard Medical School and the University of California, San Francisco examined associations between persistent pain and changes in physical and cognitive function and well-being in more than 5,500 participants. They used data on community-dwelling Medicare beneficiaries aged 65 years and older from the National Health Aging Trends Study and followed participant outcomes from 2011 to 2019.

Researchers defined persistent pain as being bothered by pain in the last month, based on two interviews conducted a year apart at the start of the study. Intermittent pain was defined as bothersome pain reported in one of those interviews only. The results were adjusted for age, sex, race, education and marital status at baseline.

39% report persistent pain

Thirty-nine percent reported persistent pain, and 28% reported intermittent pain. Those with persistent pain had reduced physical function and well-being when compared to their peers without pain at the study’s start. In addition, multiple pain sites were the norm, with more than one-third reporting pain in five or more body sites. 

Over the next seven years, participants with persistent pain also experienced relatively increased decline in physical function and well-being. Black participants were more likely to report pain than white participants.

In contrast, pain was not tied to cognitive decline or dementia progression, Alexander Smith MD, MPH, of UCSF reported.

Interventions needed

Considering that many older adults also live with painful multiple chronic conditions or are at high risk for gastrointestinal bleeding, medication management choices may be limited, Smith and colleagues noted. They recommended that clinicians undertake proactive interventions to mitigate pain in these patients.

“Given that an estimated 12 million older adults experience persistent pain and close to two-thirds experience subsequent functional decline, it is critical that access to effective treatment be made available to all,” they wrote.

“The high prevalence of pain and its untoward consequences suggest a need for a renewed policy focus on persistent pain that incorporates reimbursement for nonpharmacologic and pharmacologic approaches,” the authors concluded.

The study was published in the Journal of the American Geriatrics Society.

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