Prevalence and features of chronic pain syndrome in persons over 65 years old: Russian epidemiological study EVKALIPT

Background. The prevalence of chronic pain syndrome in general population of older adults in the Russian Federation is unknown.

Aim. To study the prevalence and features of chronic pain syndrome in subjects aged ≥65 years.

Materials and methods. There were examined 4308 subjects (30% males) aged from 65 to 107 years (mean age 78±8 years), living in 11 regions of the Russian Federation, who were divided into 3 age groups (65–74 years, 75– 84 years and ≥85 years). All participants underwent a comprehensive geriatric assessment consisted of two stages: 1) questioning based on a specially designed questionnaire; 2) physical examination. The «Chronic pain» module of questionnaire included: 1) questions concerning the presence, localization, character and frequency of chronic pain syndrome, as well as the frequency of taking analgesics; 2) self-assessment of pain intensity on a visual-analogue scale at the moment of examination and for the previous week; 3) DN4 questionnaire to detect neuropathic pain.

Results. The prevalence of chronic pain syndrome was 87.2%, including 83.8% in subjects aged 65–74 years, 87.7% — 75–84 years, 91.1% — ≥85 years (p for trend <0.001). In women, chronic pain was detected more often than in men (90.2% vs. 80.2%; p<0.001). The most frequent localization of pain syndrome were large joints (75%), back (68%) and head (64%). The prevalence of different types of pain was as follows: nociceptive — 67.3%, neuropathic — 21.2%, nociplastic — 11.4%. With age, the frequency of detection of neuropathic pain increased (from 18.9% in patients aged 65–74 to 23.8% in patients ≥85 years; p for trend = 0.013), nociplastic, on the contrary, decreased (from 13.8% to 9%; p for trend = 0.001), and nociceptive — remained unchanged (67.3% in patients aged 65–74, 67.6% — 75–84 years, 67.2% — ≥85 years; p for trend = 0.974). In patients with neuropathic pain, more severe manifestations of pain syndrome were revealed: they were more likely to experience pain of any localization with a large number of pain zones/areas, they had a higher frequency and intensity of pain syndrome, and they were more likely to take analgesics and noted limitations in daily life due to pain.

Conclusion. In the EVKALIPT study, for the first time, domestic data on the prevalence and features of chronic pain syndrome in subjects aged ≥65 years in the general population was obtained.

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