Geriatric pain. Factors that limit pain relief and increase complications

Persons age 65 and older are more likely than younger adults to experience chronic pain but less likely to obtain pain relief. Achieving adequate pain management for the older patient is complicated by comorbid diseases, increased risk of adverse drug reactions, and physician factors such as inadequate training in pain medicine and a reluctance to prescribe opioid medications. Nociception appears not to change with age or with the development of dementia, although a person's perception of pain and willingness to report it may change. Control of depression and anxiety greatly facilitates pain management. As a patient's number of medications increases, so does the risk of adverse reactions; therefore, care is required when adding any new medication to the drug regimen.