Neuropathic pain considerations in the aging population

Neuropathic pain affects especially older persons and this review aims at discussing neuropathic pain prevalence, evaluation and treatment and how to optimize management. Older persons are prone to develop neuropathic pain essentially because aging is associated with an increased incidence of comorbidities, immune dysfunction, higher prevalence of herpes zoster infections, higher occurrence of diabetes, surgical interventions and of central nervous system pathologies.

This review underlines recent publications on neuropathic pain in these different pathologies, presents a consensus focused on pharmacotherapy and an algorithm for neuropathic pain management. Combination of pharmacological and non-pharmacological approaches is suggested as essential for optimal care.

Findings underline the high neuropathic pain rate in older persons, the importance of proactively looking for the presence of pain, the adaptation and careful dosing of the pharmacotherapy in the context of adverse events and quality of life. Initiatives on neuropathic pain prevention are budding with surgical care and vaccination but need to be largely expanded to avoid the development of neuropathic pain.