Those Who Frequently Experience Significant Pain Develop Functional Problems Associated With Aging At Far Younger Ages Than Those Not In Significant
Thursday, September 3, 2009
The older they get, the more likely most adults are to have difficulty walking; climbing stairs; moving heavy loads; and managing daily activities such as bathing, dressing, and eating. These difficulties can make it hard for older people to live on their own without additional help.
Not all older adults have these difficulties, however. Some don't have problems functioning even in their 90's. But others develop problems functioning long before they're old enough to be considered "old." Because prior research found that people who are in pain are more likely to have difficulty functioning than those who are not in pain, it's possible that pain boosts risks of developing difficulty functioning early on. That could explain why some older people have difficulty functioning much earlier in life than others.
New Research in the Journal of the American Geriatrics Society
To get a better sense of how pain might affect an adult's ability to function as he or she grows older, researchers recently studied more than 18,000 adults. All were older than 50 years. And all lived in the community, rather than in nursing homes or other long-term care facilities.
The researchers asked the adults if they often experienced pain and, if so, the severity of the pain. Adults who said that they were often troubled by pain and that the pain was moderate or severe most of the time were classified as having "significant pain." The researchers also asked the adults in the study whether they had trouble walking or running various distances; climbing one or more flights of stairs; raising their arms over their heads, or carrying, pulling or pushing heavy loads. Finally, they asked the adults if they had difficulty managing, or needed help with, daily activities such as bathing, dressing, and eating.
The researchers found that adults with significant pain developed difficulties functioning at much earlier ages than those who didn't have significant pain. In fact, the adults with significant pain stated that they developed such difficulties 20 to 30 years earlier than those who didn't have significant pain. "This suggests that among persons of similar age, pain may be a crucial clinical marker for subjects at high risk of functional limitations," the researchers report in the Journal of the American Geriatrics Society.
In light of these findings, the researchers write, patients with significant pain should be evaluated for functional problems. And those with functional problems should be evaluated to determine whether they have significant pain. For those with pain and functional difficulties, treatment should focus both on pain relief and therapy to improve functioning, the researchers conclude.
What Should I Do?
The American Geriatrics Society recently updated its guidelines for treating persistent (or ongoing) pain and the AGS' Foundation for Health in Aging (FHA) has published an easy to read "tip sheet" about managing persistent pain that is based on the guideline. The tip sheet is available in both English and in Spanish. Like other tip sheets and information on www.healhtinaging.org, the FHA's public education website, these can be printed and shared at no cost.
The summary above is from the full report titled, "Pain, Functional Limitations, and Aging." It is in the September 2009 issue of the Journal of the American Geriatrics Society (Volume 57, Issue 9). The report is authored by Kenneth E. Covinsky, MD, MPH, Karla Lindquist, MS, Dorothy D. Dunlop, Ph.D, and Edward Yelin, Ph.D.