Abstract and Introduction
Abstract
Pain is often challenging to manage in the geriatric population due to age-related changes that make drug selection difficult. In addition, geriatric patients often have comorbidities that can affect drug choice and lead to polypharmacy. Polypharmacy and age-related changes increase the risk of drug intolerance and drug interactions. The presence of dementia further complicates pain management because of difficulties with pain assessment and the increased risk of cognitive adverse events with commonly prescribed medications. Uncontrolled pain in this population can also contribute to behavioral issues that can be challenging for caregivers.
Introduction
More than 36 million people worldwide are believed to suffer from dementia. The United States has the second largest population of people with dementia, about 4 million. A majority of cases of dementia occur after the age of 65 years. With rising growth rates in the elderly population, it is likely that the cases of dementia will increase accordingly.
The prevalence of pain in U.S. adults 65 years and over is variable. There are reports suggesting the rates of pain in geriatric populations are around 21% (4 million people); most of this pain is classified as persistent. Other studies have shown that over 90% of older adults experience pain, predominantly musculoskeletal. The prevalence of pain in dementia varies, largely based upon the assessment tools utilized in the studies.