[Aging and pain: specific features of neuropathy treatment in the elderly]

The changes in the somatosensory system in aging and peripheral neuropathies are similar. Higher pain sensitivity thresholds in the presence of axonopathy are accompanied by paradoxically decreased pain tolerance associated with neuroplastic changes in the spinal cord and brain. The symptomatic treatment of neuropathic pain syndrome with antidepressants, anticonvulsants, and opioids is related to the lower quality of life in elderly patients and to the high risk of severe side effects. The pathogenetic treatment of polyneuropathies frequently increases the intensity of neuropathic pain at its beginning; however, it can recover the function of an axon and reduce the degree of deficiency states. The paper discusses methods for increasing the safety of treatment for neuropathic pain in elderly patients, a relationship between the pathogenesis of nervous system aging and distal diabetic polyneuropathy, and ways of their correction.