Bruckenthal Patricia
Stony Brook University School of Nursing, NY 11794, USA.
Pain Manag Nurs. 2010 Jun;11(2 Suppl):S23-31. doi: 10.1016/j.pmn.2010.03.004.
The U.S. population aged >or=65 years is estimated to grow from 35 million in 2000 to 71.5 million in 2030, and the number of those aged >or=85 years is expected to increase from 5.3 million in 2006 to 21 million in 2050. Due to this demographic shift, the complexities of chronic pain management in the elderly will become increasingly important, necessitating a deeper understanding in the medical community of both the normal physiologic changes that occur with aging and the increased risks and vulnerabilities to pain that may be related to illness, comorbidities, or cognitive impairment. A number of factors complicate treating pain in the elderly. First, the cause of pain is often a condition that is typically not reversible. Second, effective treatment can be hampered by side effects of medications and complications from polypharmacy. Furthermore, depression, behavioral changes, and cognitive impairment commonly complicate therapy and make assessment more difficult. Both inappropriate prescribing and medication underuse are common in the elderly, as is the undertreatment of pain in this patient population in different care settings. The goal of this paper was to review appropriate use of nonpharmacologic, complementary, and alternative therapies for the comprehensive management of pain in older adults.
据估计，美国65岁及以上的人口将从2000年的3500万增长到2030年的7150万，85岁及以上的人口数量预计将从2006年的530万增加到2050年的2100万。由于这种人口结构的转变，老年人慢性疼痛管理的复杂性将变得越来越重要，这就需要医学界更深入地了解衰老过程中发生的正常生理变化，以及与疾病、合并症或认知障碍相关的疼痛风险和易感性增加的情况。有许多因素使老年人疼痛的治疗变得复杂。首先，疼痛的原因通常是一种通常不可逆的病症。其次，药物副作用和多种药物治疗的并发症可能会阻碍有效治疗。此外，抑郁症、行为改变和认知障碍通常会使治疗复杂化，并使评估更加困难。不适当的开药和药物使用不足在老年人中很常见，在不同护理环境中，该患者群体的疼痛治疗不足也很常见。本文的目的是综述非药物、补充和替代疗法在老年人疼痛综合管理中的合理应用。
