Care of the older patient with pain

The numbers of older people, particularly those older than 85 years of age, are increasing rapidly. Aging and chronic conditions contribute to the limitation in response to stress or insults in the elderly and impact assessment and management of pain. In older patients, careful evaluation of cognition is imperative to pain management, as is assessment of effectiveness and adverse reaction to treatments. Physiological alteration in body composition and renal and hepatic function alter distribution and elimination of medications and metabolites. Non-medical treatments also may be effective in managing pain and should be considered for older patients.