Geriatric Anesthesia: A Practical Guide

Geriatric Pain Patient

Author(s): Afrin Sagir*, Parker Woolley and Fangyu Chen

Pp: 171-209 (39)

DOI: 10.2174/9789815238877124010013

* (Excluding Mailing and Handling)


Chronic pain is a major cause of physical disability, poor mental health, and decreased quality of life [1,2]. The burden of chronic pain is reflected in increased medical care utilization and consequently increased healthcare costs, which are estimated at an astounding $560 billion per year [3]. CDC estimates from 2019 reveal that while 20.4% of adults in the USA live with chronic pain, the prevalence increases with advancing age [4]. 30.8% of people aged 65 years and above had chronic pain while 11.8% of them had high-impact chronic pain, which is defined as pain that causes significant restriction of self-care, social and work-related activities [5]. The impact of chronic pain is more severe in the elderly; older adults report poorer physical health and disability in comparison to younger adults [6-8]. Chronic pain in the elderly is also associated with poorer sleep, cognitive decline, dementia, and death [9-13]. With the projected increase in the elderly population in the US every year, the burden of chronic pain is only expected to increase. This chapter outlines the physiologic and pharmacologic changes that happen with ageing, the major causes of chronic pain in the elderly, as well as the myriad of treatment options available with a focus on pharmacotherapy, behavioral and alternative therapies, and interventional pain therapies. The focus of treatment is not only targeted towards reducing pain but special considerations should be made to minimize the cognitive effects of polypharmacy in light of multiple comorbidities and promote mental well-being and functional independence [14].

Keywords: Geriatric pain, Geriatric pain assessment, Interventional pain management, Neuromodulation, Radiofrequency ablation, Spinal cord stimulation.

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