National Ageing Research Institute, Poplar Road Parkville, Victoria, Australia.
Pain Med. 2012 Apr;13 Suppl 2:S23-6. doi: 10.1111/j.1526-4637.2012.01349.x.
With the ageing of the world's population, any health problem which adversely affects quality of life in older persons becomes increasingly salient. Persistent pain is one of the most prevalent health conditions faced by adults of advanced age, and is recognized as a major concern for this segment of the population.
Numerous epidemiologic surveys suggest that pain is most common during the late middle-aged phase of life (55-65 years) and continues at approximately the same prevalence into older age (65+). This is true regardless of the anatomical site or the pathogenic cause of pain. The one exception appears to be pain associated with degenerative joint disease (e.g., osteoarthritis) which shows an exponential increase until at least 90 years of age. Common age associated conditions like dementia may result in a reduced frequency and intensity of pain. Daily pain is a major risk factor for developing disability and the oldest age cohorts are most vulnerable. Discretionary and higher order physical activities appear most affected, while basic activities of daily living may be modified but are rarely ceased altogether. Similar relationships have been documented for risk of depression and mood disturbance in older persons with persistent pain. Despite such well characterized adverse impacts, pain often remains poorly treated in older persons. This occurs across all health care settings examined (i.e., emergency, acute, outpatient, long-term care).
Improved knowledge for both health professionals and patients, addressing the current research gaps and expansion of age-appropriate pain management services will be required to better meet the needs of our rapidly ageing population.
随着世界人口老龄化，任何对老年人生活质量产生不利影响的健康问题都变得越来越突出。持续性疼痛是老年人最常见的健康问题之一，被认为是这一年龄段人群的主要关注点。
许多流行病学调查表明，疼痛在中老年阶段（55-65 岁）最为常见，并以大致相同的患病率持续到老年（65 岁以上）。无论疼痛的解剖部位或病因如何，都是如此。一个例外似乎是与退行性关节疾病（如骨关节炎）相关的疼痛，这种疼痛至少在 90 岁之前呈指数增长。常见的与年龄相关的疾病，如痴呆症，可能会导致疼痛的频率和强度降低。日常疼痛是导致残疾的主要危险因素，而最年长的年龄组人群最易受到影响。随意和更高阶的身体活动似乎受到的影响最大，而基本的日常生活活动可能会改变，但很少完全停止。在有持续性疼痛的老年人中，也有类似的风险因素记录，如抑郁和情绪障碍。尽管存在如此明确的不利影响，但老年人的疼痛往往仍得不到很好的治疗。这种情况发生在所有检查过的医疗保健环境中（即急诊、急性、门诊、长期护理）。
需要提高卫生专业人员和患者的知识水平，解决当前的研究差距，并扩大适合年龄的疼痛管理服务，以更好地满足我们快速老龄化人口的需求。
