Preserved Capacity for Placebo Analgesia in the Elderly.
The prevalence of chronic pain rises with increasing age. It has been suggested that the mechanisms responsible for the development of chronic pain overlap with mechanisms involved in aging, potentially implicating age-related changes in descending modulatory pathways. This observation raises the question whether other forms of endogenous pain modulation, in particular placebo analgesia, become compromised with age. Because of the known contribution of placebo effects to analgesic treatment outcomes this question is of important clinical relevance. In this study, we compared the response to thermal painful stimuli and the capacity for endogenous pain modulation between younger and older adults using a well established placebo analgesia paradigm involving expectancy and conditioning components. We recruited 30 younger (age 23-40 years, mean = 27.04, standard error of the mean ± .61) and 24 older adults (60-80 years, mean = 69.3, standard error of the mean ± .89). We observed increased heat pain thresholds and higher pain intensity ratings (in response to physically identical heat stimulation) in the older compared with the younger group. However, the placebo analgesic response was comparable between both age groups of healthy participants. The preserved capacity for placebo analgesia in our sample of older participants highlights the potential to use nonpharmacological analgesic treatment strategies in this age group and to exploit placebo mechanisms as an add-on to existing analgesic (pharmacological) treatment strategies.



In contrast to the commonly shared view that endogenous pain modulation declines with age we found a comparable capacity for placebo analgesia in a group of healthy older and younger adults.
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany. Electronic address: nathalie.wrobel@ki.se.
Nathalie
N
Wrobel
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Tahmine
T
Fadai
Department of System Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Stefanie
S
Brassen
Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Ulrike
U
Bingel
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000704:Analysis of Variance; D058443:Catastrophization / Q000523:psychology; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation / Q000009:adverse effects; D015990:Placebo Effect; D011795:Surveys and Questionnaires; D013696:Temperature; D055815:Young Adult
Lifespan; adults; elderly; endogenous pain modulation; expectation; experimental pain; learning; placebo analgesia; placebo effect