Older Age Linked to Decreased Perception of Acute Visceral Pain

Decreased pain reporting can cause misdiagnosis, delayed treatment, and complications.

Older patients may perceive less pain for certain acute visceral conditions than their younger counterparts, according to a study published in the Journal of Emergency Medicine.1

Analyzing data for more than 15 000 patients presenting to the emergency department, Raoul Daoust, MD, MSC, and colleagues from the University of Montreal and Sacre-Coeur Hospital of Montreal in Quebec, Canada, found that pain scores for renal colic, pancreatitis, appendicitis, and headache/migraine decreased linearly with age, but those for dislocations and extremity fractures did not.

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This is the first and largest study to look at the impact of age on pain perception, the authors write, noting that decreased pain reporting in older patients could lead to misdiagnosis, delayed treatment, and complications.

Although the effect sizes observed in the study were small, the findings are supported by prior research showing that older adults have a blunted response to pain, Alexis LaPietra, DO, a spokeswoman for the American College of Emergency Physicians, who was not involved in the study, told Clinical Pain Advisor.

“The article reminds us that geriatric patients aren’t going to present with severe pain like we suspect,” said Dr LaPietra, a fellowship director for emergency medicine and pain management at St. Joseph’s Regional Medical Center in Paterson, New Jersey.

“This article takes what we suspected in the research realm and it puts it in front of us day to day. It helps use to appreciate clearly that these groups differ and we can’t treat 75-year-old patients as we would a 44-year-old patient,” Dr  LaPietra added.