Impact of age, gender and cognitive functioning on pain perception.
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.


METHODS
(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.


CONCLUSIONS
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.
Pickering
Gisèle
G
Inserm Epi 9904, Clinical Pharmacology Department, University Hospital, Clermont-Ferrand, France. gisele.pickerin@u-clermont1.fr
Jourdan
Didier
D
Eschalier
Alain
A
Dubray
Claude
C
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D003071:Cognition; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D017288:Pain Threshold; D010465:Perception; D012727:Sex Characteristics