Department of Cardiology and Cardiac Surgery, Medical Faculty, Collegium Medicum, University of Warmia and Masuria, Olsztyn, Poland.
Department of Internal Medicine and Gerontology, Collegium Medicum, Jagiellonian University, Cracow, Poland.
Med Sci Monit. 2019 Apr 12;25:2695-2701. doi: 10.12659/MSM.911260.
BACKGROUND The prevalence of chronic pain among the elderly is high (estimated at 25-85%) and may adversely affect their everyday functioning, although it is often unrecognized. MATERIAL AND METHODS The aim of this study was to assess the prevalence of chronic pain, especially with the neuropathic component, and its effect on overall functioning of elderly patients. We enrolled 145 subjects older than 60 years (nursing home residents, or patients of outpatient geriatric clinic). Information on co-morbidities, functional and mental status, and medications was obtained using a questionnaire. Chronic pain was defined as lasting >3 months and the presence of neuropathic component was detected using the DN4 Questionnaire (Douleur Neuropathique en Questions). RESULTS The mean age of patients was 76±9.68 years. Chronic pain was reported by 78% of participants and 32% reported neuropathic pain with neuropathic component (DN4 score ≥4 points). Patients complaining of chronic pain significantly more often presented mood disorders and lower satisfaction with life (particularly those with the highest pain intensity), with no difference in functional status according to the ADL (Activities of Daily Living) tool. Participants with chronic pain were treated with paracetamol (45%), non-steroidal anti-inflammatory drugs (25%), and opioids (24%). CONCLUSIONS The prevalence of chronic pain, particularly with neuropathic component, in the elderly population seems to be higher than expected based on previous reports, and its treatment appears to be ineffective. This problem requires further research and dissemination of knowledge on the diagnosis and treatment of chronic pain among health care workers caring for elderly patients on a daily basis.
背景:老年人慢性疼痛的患病率较高(估计为 25-85%),尽管常常未被识别,但可能会对他们的日常功能产生不利影响。
材料和方法:本研究旨在评估老年患者慢性疼痛(尤其是伴有神经病理性成分的疼痛)的患病率及其对整体功能的影响。我们招募了 145 名年龄在 60 岁以上的受试者(养老院居民或老年门诊患者)。使用问卷获取合并症、功能和精神状态以及药物使用信息。慢性疼痛定义为持续时间超过 3 个月,通过 DN4 问卷(Douleur Neuropathique en Questions)检测是否存在神经病理性成分。
结果:患者的平均年龄为 76±9.68 岁。78%的参与者报告有慢性疼痛,32%的参与者报告有伴有神经病理性成分的神经病理性疼痛(DN4 评分≥4 分)。报告有慢性疼痛的患者更频繁地出现情绪障碍和生活满意度降低(尤其是那些疼痛强度最高的患者),但根据 ADL(日常生活活动)工具,其功能状态无差异。有慢性疼痛的参与者接受了对乙酰氨基酚(45%)、非甾体抗炎药(25%)和阿片类药物(24%)治疗。
结论:与以往报告相比,老年人慢性疼痛(特别是伴有神经病理性成分的疼痛)的患病率似乎更高,其治疗效果似乎不佳。这一问题需要进一步研究,并向日常照顾老年患者的医护人员传播有关慢性疼痛的诊断和治疗知识。