Balancing pain and analgesic treatment in the home-dwelling elderly

Background: In elderly persons, pain is a common problem, and analgesic medicines are among the most frequently used drugs. Objective: To describe the use of analgesic medication and its relation to daily pain and morbidity in home-dwelling elderly people aged at least 75 years. Methods: A random sample of 700 subjects aged at least 75 years was drawn from the total population of Kuopio, Finland. A geriatrician and nurse carried out structured clinical examinations and interviews with 601 persons, 523 of whom were living at home. Results: Seventy percent (n=364) of the elderly people were taking at least one analgesic, including most of those who suffered from daily interfering pain (85%) and nearly all of those experiencing daily pain at rest (93%). Nonsteroidal antiinflammatory drugs (NSAIDs; n=226, 51%) and acetaminophen (n=118, 23%) were the most commonly used analgesics. The use of opioids became more common with age, accounting for 16% of the drugs in the oldest patients (greater than or equal to85 y) and 6% among those aged 75-79 years. Analgesics were mainly taken when needed. Only 13% of NSAID users, 18% of acetaminophen users, and 21% of opioid users took these preparations regularly. Conclusions: Although analgesics are commonly used by elderly patients, it appeared that many patients were still experiencing daily interfering pain and pain at rest.