The epidemiology of pain in elderly people

      The population prevalence and characteristics of pain complaints are difficult to ascertain and to compare across studies.
      • Crombie I.K.
      • Croft P.R.
      • Linton S.J.
      • et al.
      In addition, most studies cannot take into account the many pain problems that afflict each person sampled,
      • Ferrell B.A.
      • Ferrell B.R.
      • Osterweil D.
      Pain in the nursing home.
      • Mobily P.R.
      • Herr K.A.
      • Clark M.K.
      • et al.
      An epidemiologic analysis of pain in the elderly: The Iowa 65+ Rural Health Study.
      but which are so shortlived because of rapid resolution, infrequent recurrence or mortality, that they do not show up in cross-sectional prevalence studies. For example, the pain and suffering associated with fractures and cancer is usually not apparent in epidemiologic studies. Even chronic conditions well known to increase with age, such as central poststroke pain
      • Leijon G.
      • Boivie J.
      • Johansson I.
      Central post-stroke pain: Neurological symptoms and pain characteristics.
      and postherpetic neuralgia,
      • Portenoy R.K.
      • Duma C.
      • Foley K.M.
      Acute herpetic and postherpetic neuralgia: Clinical review and current management.
      rarely are featured because of their low incidence compared with the overwhelming frequency and chronicity of degenerative joint disease. Most prevalence studies are also unable to incorporate the large number of questions needed to adequately describe the pain experience: where is the site of pain; is it continuous or intermittent; what has been its duration; what is its quality and severity at different times; how is it aggravated and relieved; and how has it been treated? These are only some of the clinical questions we might legitimately ask in any such study, and this ignores the impact on quality of life and mood, the effects of and on comorbidity, and effects on caregivers.
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