Last Years of Life Painful for Many Older Adults

For those with arthritis, 60 percent deal with pain in their last month of life

TUESDAY, Nov. 2 (HealthDay News) -- Many older adults have clinically significant pain over the last two years of life, especially those with arthritis, according to a study in the Nov. 2 issue of the Annals of Internal Medicine.

Alexander K. Smith, M.D., of the University of California in San Francisco, and colleagues conducted an observational study of pain in the last two years of life using interview data from 4,703 participants or proxies, who were placed into one of 24 cohorts on the basis of the number of months between the interview and death.

The researchers found that, at 24 months prior to death, the prevalence of pain was 26 percent; this remained flat until four months prior to death, and it reached 46 percent in the last month of life. Among the subgroup of patients with arthritis, the pain prevalence in the last month was 60 percent, compared to only 26 percent in the subgroup without arthritis. Pain prevalence in the last month did not differ by the category of diagnosis at death.

"This study has important clinical implications. All physicians, regardless of specialty, should routinely assess for and be prepared to treat clinically significant pain," writes the author of an accompanying editorial. "In light of several patient-level barriers to managing pain in later life, clinicians should ask patients not only whether they hurt but also about their preferences for treatment approaches."

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