Age Differences in the Quality of Chronic Pain: A Preliminary Study

Abstract

BACKGROUND: Recent studies of the relationship between age and the intensity of chronic pain report increases, decreases or no change in pain intensity as a function of age. These inconsistencies may be due in part to the pain assessment tools employed and their appropriateness with different age groups.OBJECTIVES: To assess age differences in chronic pain by using several measures of pain intensity and a multidimensional measure of pain qualities in the same sample; to assess the consistency of pain intensity estimates obtained from different scales within age groups; to determine whether the failure rates for appropriately completing the scale (such as choosing more than one descriptor or making more than one mark on the Visual Analog Scale [VAS]) differ among age groups.SUBJECTS: Seventy-nine adults aged 27 to 79 years with chronic arthritis pain.MEASUREMENTS: The unidimensional pain intensity scales used were the VAS, the Verbal Descriptor Scale and the Behavioural Rating Scale. The multidimensional pain scale used was the short form McGill Pain Questionnaire (SF-MPQ). The Beck Depression Inventory was also administered.RESULTS: Age-related decreases were found in the sensory and affective dimensions of chronic pain as measured with the SF-MPQ. No age differences in pain intensity were measured with any of the unidimensional scales. These results were maintained after controlling for the effects of concurrent depressive symptomatology. Pain intensity estimates differed within groups, with verbal descriptors yielding the most consistent estimates in the elderly group. The elderly were significantly more likely to fail on the VAS than younger subjects. There were no age differences on any other measure.CONCLUSIONS: There may be age-related changes in the quality but not in the intensity of chronic arthritis pain. Implications for clinical pain assessment in the elderly are discussed.