A Biopsychosocial Model of Chronic Pain for Older Adults

Abstract

Population Comprehensive evaluation of chronic pain in older adults is multifaceted. Objective and Methods Research on chronic pain in older adults needs to be guided by sound conceptual models. The purpose of this paper is to describe an adaptation of the Biopsychosocial Model (BPS) of Chronic Pain for older adults. The extant literature was reviewed, and selected research findings that provide the empiric foundation for this adaptation of the BPS model of chronic pain are summarized. The paper concludes with a discussion of specific recommendations for how this adapted model can be used to guide future research. Conclusions This adaptation of the BPS model of chronic pain for older adults provides a comprehensive framework to guide future research in this vulnerable population.

Biopsychosocial Factors Predicting Pain Among Individuals Experiencing the Novel Coronavirus Disease (COVID-19)

“…In addition, fatigue increases negative illness perception in individuals, and this leads to diseaserelated symptoms, including pain, shortness of breath, and insomnia. Individuals suffering from fatigue are unable to suppress long-term pain, have trouble coping with it, and consequently experience greater pain (Miaskowski et al, 2020;Nijrolder, van der Windt, Twisk, & van der Horst, 2010). Considering these findings, it is considered that fatigue may increase pain due to stimulation in the central nervous system and changes in the expression of neurotransmitters, including serotonin and dopamine (Clauw, Häuser, Cohen, & Fitzcharles, 2020;Townsend et al, 2020).…”

“…Individuals with anxiety experience excessive muscle tension, and this condition especially triggers muscle pain by causing physiological stimulation. In this context, anxiety is emphasized as a factor that increases pain severity and the perceived disease burden (Lumley et al, 2011;Miaskowski et al, 2020). In other words, it is a cyclic phenomenon; as anxiety increases pain, pain also triggers anxiety.…”

“…Accordingly, the biopsychosocial model of pain was adapted to elucidate the multidimensional nature of pain (Gatchel, Ray, Kishino, & Brindle, 2020). The model has been identified as the most successful model to date for understanding pain (Gatchel et al, 2020;Miaskowski et al, 2020). The developers of the model argues that each individual is unique, and therefore, biological, psychological, and social factors are necessary for defining subjective pain (Gatchel et al, 2020).…”

“…The social factors comprise race, ethnicity, culture, socioeconomic status, ageism, education level, marital status, employment status, social support, and activity level of the patient (Miaskowski et al, 2020). Studies indicate that approximately 70% of individuals with COVID-19 have a decline in physical activity (Tison et al, 2020;Woods et al, 2020).…”

A Paradigm Shift for Movement-based Pain Assessment in Older Adults: Practice, Policy and Regulatory Drivers

“…Other countries report similar prevalence rates: 32% in Iran (Roghani, Delbari, Asadi-Lari, Rashedi, & Lokk, 2019) and 41% in China (Si et al, 2019). Given these data, the negative consequences of underrecognized and undertreated pain in older adults (Horgas, 2017) and the importance of a biopsychosocial model of pain (Miaskowski et al, 2019), accurate and meaningful assessment of pain is essential to assure pain is recognized, appropriately evaluated, and treatment planning initiated. It is important that the assessment of pain in this population be guided by current research and subsequent best-practice recommendations.…”