• Manu Thakral, Ling Shi, Janice B Foust, Kushang V Patel, Robert H Shmerling, Jonathan F Bean, and Suzanne G Leveille.
• aGroup Health Research Institute, Seattle, WA, USAbCollege of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USAcCenter for Pain Research on Impact, Measurement and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USAdDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USAeDivision of Rheumatology, Beth Israel Deaconess Medical Center, Boston, MA, USAfSpaulding Rehabilitation Hospital, Boston, MA, USAgDepartments of Medicine and Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
• Pain. 2016 Dec 1; 157 (12): 2834-2842.

AbstractThis study aimed to characterize the prevalence of various pain qualities in older adults with chronic nonmalignant pain and determine the association of pain quality to other pain characteristics namely: severity, interference, distribution, and pain-associated conditions. In the population-based MOBILIZE Boston Study, 560 participants aged ≥70 years reported chronic pain in the baseline assessment, which included a home interview and clinic exam. Pain quality was assessed using a modified version of the McGill Pain Questionnaire (MPQ) consisting of 20 descriptors from which 3 categories were derived: cognitive/affective, sensory, and neuropathic. Presence of ≥2 pain-associated conditions was significantly associated with 18 of the 20 pain quality descriptors. Sensory descriptors were endorsed by nearly all older adults with chronic pain (93%), followed by cognitive/affective (83.4%) and neuropathic descriptors (68.6%). Neuropathic descriptors were associated with the greatest number of pain-associated conditions including osteoarthritis of the hand and knee. More than half of participants (59%) endorsed descriptors in all 3 categories and had more severe pain and interference, and multisite or widespread pain than those endorsing 1 or 2 categories. Strong associations were observed between pain quality and measures of pain severity, interference, and distribution (P < 0.0001). Findings from this study indicate that older adults have multiple pain-associated conditions that likely reflect multiple physiological mechanisms for pain. Linking pain qualities with other associated pain characteristics serve to develop a multidimensional approach to geriatric pain assessment. Future research is needed to investigate the physiological mechanisms responsible for the variability in pain qualities endorsed by older adults.

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