Humanaging is a gradual and adaptive process characterized by the loss of physical
and cognitive capacities without any evidence of a defined disease. Pain is by
far one of the most common symptoms presented in daily clinical practice. When
pain persists for longer than three months, it is defined as Chronic Pain (CP),
and it can transform from a symptom to an independent medical condition. In
geriatric patients, the management of CP becomes increasingly complicated
because of age-related homeostatic imbalances, especially in systems related to
pain perception, pain inhibition and pain interpretation. The assessment of CP
in elders becomes a challenge for many reasons, including cognitive
impairments, lack of family support and/or abuse, the existence of
comorbidities and polypharmacy; such factors can cause CP to be underestimated
in this population. In addition to the implications of unidentified or
incorrectly treated CP for life quality and mood equilibrium, its recent
association with frailty in elders makes it a potential risk factor for an
established and irreversible functional limitation state.
WhenCP is established, regardless of its cause, general alterations in the organism
are triggered, as many authors have noted. Nevertheless, when considering elder
patients from an integrated geriatric point of view, there are main factors and
systems involved that could play a key role in the predisposition to develop
frailty. Two main aspects need to be addressed: the perception of pain and the
pathophysiological adaptation to CP.
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