The Relation of Pain to Depression Among Institutionalized Aged

Parmelee, Patricia A.; Katz, Ira R.; Lawton, M. Powell

doi:10.1093/geronj/46.1.p15

Cited by 355 publications

(195 citation statements)

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“…Diabetic Control group, n (%) group, n (%) plain about more intense, localized pain and have a larger number of pain complaints than non-depressed patients [16,4]. The prevalence of depression in our study was greater in the DG patients than in the CG patients (13% versus 3%) (× 2 =3.78, p=0.052), and all of them reported a poor outcome.…”

Section: Complicationmentioning

confidence: 51%

Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Arinzon¹,

Adunsky

Fidelman³

et al. 2004

European Spine Journal

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Section: Complicationmentioning

confidence: 51%

Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Arinzon¹,

Adunsky

Fidelman³

et al. 2004

European Spine Journal

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“…[2] The association between pain and depressed mood is well established for older adults residing both in the community [82] [125] and in institutional settings. [20] [93] This means that a large proportion of older adults experiencing chronic pain will have significant depressive symptoms at some time and may benefit dramatically from psychological or psychiatric intervention. [36] [41] Recognition and effective treatment of the underlying pain may alleviate the patient's depressed mood; however, when this is not the case, it is crucial to treat the concomitant mood disorder because failure to do so results in ineffective pain management.…”

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

342

251

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Although the empirical base is still limited when providing clear directions for pain assessment and management in older adults, it is possible to identify recommendations for guiding practice based on consensus and a developing scientific base to support best practice activities. This article offers a brief overview of the epidemiology and consequences of pain, followed by a summary of issues and approaches relevant to pain assessment in older adults. Cohort specific recommendations for comprehensive pain assessment and measurement are then addressed. Prevalence and Consequences of Pain in Older AdultsOlder individuals frequently suffer from both acute and chronic painful diseases, have multiple diseases, and take numerous pain medications, [2] although relatively little investigative or clinical attention has been paid to the assessment of pain in the geriatric population, compared with the general population. This is surprising because populationbased figures indicate that the prevalence of pain is twofold higher in those over age 60 (250 per thousand), compared with those under age 60 (125 per thousand). [24] [79] [108] Further, prevalence estimates suggest that approximately 60% of community-dwelling older adults and up to 80% of elderly long-term care facility residents experience substantial pain.[24] [79] [108] Because pain is often remediable, [2] [25] it is thought that the high prevalence estimates of unrelieved pain in elderly persons may result from underrecognition, which in turn results in undertreatment. [65] [91] [120] The consequences of untreated pain can profoundly impact the older person's quality of life. In addition to physiologic risks associated with untreated pain (e.g., cough suppression with subsequent retention of pulmonary secretions), depression, [58] [39] [90] Therefore, it is imperative that health care professionals' knowledge and skills related to pain assessment in older adults be improved, and aggressive approaches to comprehensive pain assessment be adopted, to ensure and improve the quality of life of our senior citizens. Approaches to Pain Assessment with Older Adults Clinical AssessmentIn the clinical setting, accurate assessment of pain is critical for the identification of appropriate interventions and for evaluating the effectiveness of such interventions. Patients should be assessed regularly for the presence of pain and for improvement, deterioration, or complications attributable to pain treatment.[2] The frequency of the follow-up should be a function of the severity of the pain and the potential for adverse effects of treatment. Documentation of pain assessment formalizes the pain assessment process and is essential in the provision of individualized care from both a legal and professional perspective. [17] Inherent in the assessment of pain among older adults is the understanding of its potentially remediable components. For example, if a patient has acute pain, assessment should focus on the underlying pathology responsible for the pain stimulus. If th...

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“…It may also -being a factor of behavior inhibition -be conducive to intensification of depressive symptoms, including psychomotor slowness, anergy and withdrawal. Patients, instead of complaining signal, often pain in a more subtle way, through nonverbal expression (Shega et al, 2004;Feldt, 2000) and symptoms of depression -worsening of quality of sleep, appetite decrease, withdrawal from activities of daily life (Cohen-Mansfield et al, 1990;Megni et al 1993;Dworkin et al, 1990;Parmelee et al, 1991) or agitation (Buffum et al, 2000). In the elderly, there is a strong relationship between sensed pain and depression, stronger than in the young adults (Turk, Okifuji, Scharff, 1995).…”

Section: Health Management 46mentioning

confidence: 99%