Luttosch F, Baerwald C
Sektion Rheumatologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
Z Rheumatol. 2014 Apr;73(3):233-43. doi: 10.1007/s00393-013-1244-4.
Given the current demographic changes there are an increasing number of elderly and very elderly patients in outpatient and inpatient care. Elderly and very elderly patients often suffer from pain and musculoskeletal conditions are a common cause of pain in the elderly. An effective pain management should not be withheld from elderly patients with rheumatic diseases. Untreated pain in elderly patients leads to functional impairment and immobility. In addition, the quality of life of patients is negatively affected and can lead to a loss of autonomy and/or social withdrawal. The treatment of elderly and very elderly patients is particularly challenging. There are special features that need to be considered in the choice of treatment. Altered pain presentation, comorbidities, nonadherence, polypharmacy and side effects of pain medications require a critical risk-benefit assessment and ongoing treatment monitoring of this special group of patients.
鉴于当前的人口结构变化，门诊和住院护理中老龄及高龄患者的数量日益增加。老龄及高龄患者常遭受疼痛，肌肉骨骼疾病是老年人疼痛的常见原因。对于患有风湿性疾病的老年患者，不应拒绝给予有效的疼痛管理。老年患者未经治疗的疼痛会导致功能障碍和行动不便。此外，患者的生活质量会受到负面影响，并可能导致自主性丧失和/或社交退缩。老龄及高龄患者的治疗尤其具有挑战性。在选择治疗方法时需要考虑一些特殊因素。疼痛表现的改变、合并症、不依从性、多种药物治疗以及止痛药物的副作用，都需要对这一特殊患者群体进行严格的风险效益评估和持续的治疗监测。
