Impact of Age, Gender and Cognitive Functioning on Pain Perception

Abstract

Background: Experimental data on nociception in the elderly have so far been contradictory and most of these have been obtained using psychophysical methods with little attention paid simultaneously to the state of cognition and the psychometric performance of the subjects. Objective: The aim of this study was twofold: (1) to evaluate the impact of age on experimental nociception thresholds, and (2) to investigate the interactions of age, sex, cognition and psychometric performance with nociception thresholds. Methodology: (1) Two groups, one young and one elderly, of 42 healthy participants each, 21 males and 21 females, were compared as regards nociception thresholds with thermal and mechanical stimuli (heat and pressure detection and tolerance thresholds). (2) The elderly group took cognitive (mini-mental test), psychometric (choice reaction time) and psychophysical tests in auditory (sensibility, tolerance, discrimination) and nociceptive fields. Results: This study shows that (1) pressure nociception decreases with age especially in males, while thermal thresholds are not modified, and (2) correlations exist between cognitive function, psychometric performance, tolerance to loud sounds and tolerance to mechanical noxious stimuli. Conclusion: Our results suggest that cognitive and psychomotor parameters have to be taken into account when assessing experimental nociception in the elderly. Further studies are needed to evaluate possible report biases and to assess these interactions in old patients with pain and in mildly sensory, cognitive or motor impaired elderly subjects.

Sex differences in age-related changes on peripheral warm and cold innocuous thermal sensitivity

“…Furthermore, research has shown that the sensitivity of the skin to such stimuli declines with ageing [7,8,9,10,11]. From the present study there is clear evidence that thermal sensitivity declines with ageing to both a cold Whilst the present study supports previous research, it also adds to our current knowledge about the decline in thermal sensitivity with ageing and how it differs between the two sexes.…”

“…Impaired cutaneous vascular function and delays in the sweating and shivering thresholds have been reported in age comparison studies [2,3,4,5,6]. Likewise, reduced thermal sensations in older adults have been reported, alongside a number of other tactile responses (touch, pressure and noxious thermal sensitivity) [7,8,9,10,11]. With an increasing ageing population and increased reports of climate change, understanding the age related changes in our ability to thermoregulate is vitally important.…”

Effect of Age, Sex and Gender on Pain Sensitivity: A Narrative Review

“…[35,105] and decreasing with age in others e.g. [15,31]. We suggested that a combined research approach should include a full battery of quantitative sensory testing to examine the same body sites under the same settings of different age groups to better inform the literature.…”

“…For example, while decreased pain thresholds in the elderly have been reported in studies using mechanical pressure [15,31] and ischemic pain stimuli [32] pain thresholds to electrical stimuli seem to be relatively unchanged [17] and pain thresholds to thermal stimuli, with few exceptions e.g. [33] appear to increase with aging [34 -38].…”

Pain from intramuscular vaccine injection in adults

“…Lautenbacher et al 8 reported that the thresholds for non-noxious stimuli increase with age, whereas the pressure pain thresholds decrease, although the heat pain threshold showed no age-related changes. Pickering et al 9 reported that pressure nociception decreases with age especially in males, while thermal thresholds are not modifi ed. In addition, relative decreases were observed in the frequency and intensity of pain associated with visceral disease, musculoskeletal conditions, and malignancies in adults of advanced age 21 .…”