Health risk appraisal in older people 3: prevalence, impact, and context of pain and their implications for GPs.
BACKGROUND
Pain is a common experience in later life. There is conflicting evidence of the prevalence, impact, and context of pain in older people. GPs are criticised for underestimating and under-treating pain.


OBJECTIVE
To assess the extent to which older people experience pain, and to explore relationships between self-reported pain and functional ability and depression.


METHODS
Secondary analysis of baseline data from a randomised controlled trial of health risk appraisal.


METHODS
A total of 1090 community-dwelling non-disabled people aged 65 years and over were included in the study from three group practices in suburban London.


METHODS
Main outcome measures were pain in the last 4 weeks and the impact of pain, measured using the 24-item Geriatric Pain Measure; depression symptoms captured using the 5-item Mental Health Inventory; social relationships measured using the 6-item Lubben Social Network Scale; Basic and Instrumental Activities of Daily Living and self-reported symptoms.


RESULTS
Forty-five per cent of women and 34% of men reported pain in the previous 4 weeks. Pain experience appeared to be less in the 'oldest old': 27.5% of those aged 85 years and over reported pain compared with 38-53% of the 'younger old'. Those with arthritis were four times more likely to report pain. Pain had a profound impact on activities of daily living, but most of those reporting pain described their health as good or excellent. Although there was a significant association between the experience of pain and depressed mood, the majority of those reporting pain did not have depressed mood.


CONCLUSIONS
A multidimensional approach to assessing pain is appropriate. Primary care practitioners should also assess the impact of pain on activities of daily living.
Carmaciu
Claudia
C
Department of Primary Care and Population Sciences, University College London, London, UK.
Iliffe
Steve
S
Kharicha
Kalpa
K
Harari
Danielle
D
Swift
Cameron
C
Gillmann
Gerhard
G
Stuck
Andreas E
AE
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology*; D005194:Family Practice; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D010146:Pain / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D015995:Prevalence; D011788:Quality of Life; D012044:Regression Analysis
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