Desmeules J, Allaz A F, Binyet S, Piguet V, Vogt N, Dayer P
Division de pharmacologie clinique, HCUG, Genève.
Schweiz Med Wochenschr. 1994 Nov 5;124(44):1948-51.
This retrospective study considers the influence of chronological age on the perception and consequential effects of chronic non-cancer pain in 203 patients referred to an ambulatory pain clinic. One patient in four (50) was 65 years or older. Pain had existed for more than a year in 66%. It was referred to an "unbearable" by 54% of elderly adults vs 44% (NS) of the younger adult population, and as "intense" by 61% vs 44% (p < 0.05). A higher proportion of neurogenic pain (54% vs 26%, p < 0.05) could explain this significant difference. Cognitive factors could also have amplified the painful syndrome since 59% (vs 54%) of the elderly considered they had received insufficient information on the potential consequences of their painful condition. However, despite a higher occurrence of other severe illnesses in the elderly (52% vs 35%, p < 0.05), they appear to worry less about their health problems (58% vs 78%, p < 0.01). Finally, in spite of increased severity of pain in the elderly, depression scores and consequential effects are similar in the two populations. In conclusion, the intensity of chronic pain appears to be more severe in the elderly, perhaps due to its more frequent neuropathic origin. Nonetheless, its repercussions on daily life activity seem no worse than for younger adults, and could reflect better coping strategies towards chronic pain.
这项回顾性研究考察了年龄对203名前往门诊疼痛诊所就诊患者的慢性非癌性疼痛认知及相应影响的作用。四分之一（50名）患者年龄在65岁及以上。66%的患者疼痛已持续一年以上。54%的老年人认为疼痛“无法忍受”，而年轻人群体中这一比例为44%（无统计学差异）；61%的老年人认为疼痛“剧烈”，年轻人群体中这一比例为44%（p<0.05）。较高比例的神经源性疼痛（54%对26%，p<0.05）可以解释这一显著差异。认知因素也可能加剧了疼痛综合征，因为59%（对比54%）的老年人认为他们未得到关于自身疼痛状况潜在后果的充分信息。然而，尽管老年人中其他严重疾病的发生率更高（52%对35%，p<0.05），但他们对自身健康问题的担忧似乎更少（58%对78%，p<0.01）。最后，尽管老年人疼痛程度加剧，但两组人群的抑郁评分及相应影响相似。总之，慢性疼痛强度在老年人中似乎更为严重，可能是由于其神经病理性起源更为常见。尽管如此，其对日常生活活动的影响似乎并不比年轻人更严重，这可能反映出老年人对慢性疼痛有更好的应对策略。
