Special issues in the management of chronic pain in older adults

Pain syndromes are prevalent among older individuals and generally increase in incidence as the population ages. Yet, pain often is undertreated in older patients, sometimes due to difficulties in assessing pain intensity and the effectiveness of treatment in the context of age-related cognitive impairment and physiologic changes. As a result, older patients with chronic pain conditions are more likely to experience greater functional limitations and decreased quality of life due to these and other barriers to appropriate care. This article discusses the epidemiology, assessment, and management of pain in older adults, and reviews special issues in the treatment of this population, such as adverse effects due to changes in drug metabolism and drug-drug interactions.