Year: 2005-06 (current)

Summary: The present study aimed to examine the extent and nature of pain knowledge, and explore the relationship between age, knowledge, pain beliefs, coping style and psychosocial adjustment to chronic pain. An exhaustive convenience sample of 200 patients was drawn from three multidisciplinary outpatient treatment clinics. Questionnaire measures of pain, mood disturbance, quality of life, coping strategy use, pain beliefs and pain knowledge were administered as part of the routine assessment on admission to each clinic. A new pain knowledge questionnaire was also developed to assess broad propositional knowledge about chronic pain and appropriate management approaches. Advanced age was associated with reduced self-reported pain, mood disturbance and a better quality of life, and these aspects of clinical presentation were also associated with increased levels of pain knowledge.

Multiple regression analyses showed that mood disturbance, pain and self-rated physical functioning were best predicted by age, pain beliefs and coping, whereas increased pain knowledge was an independent predictor of better self-rated general health.

Year: 2005-06 (current)

Summary: This ongoing research program aims to investigate the age-differences in self reported levels of pain, depression, anxiety, disability, coping mechanisms, pain beliefs and attitudes and quality of life in patients suffering from chronic pain. A secondary aim is to investigate the most reliable and valid questionnaires for measuring these constructs. All patients attending the NARI/MECRS pain clinic, the Caulfield pain management clinic and the Kingston Centre pain clinic provide questionnaire information on admission and discharge from the clinics. Significant age differences were observed in self-reported levels of pain, mood disturbance, disability and perceived interference ratings with daily activities, sleep, social and family relationships. In addition, a significant overall post treatment improvement was found across all measures (a 10%-40% change depending on which measure and age group is considered).

Noteable age differences in psychosocial aspects of chronic pain suggest that treatment modalities need to be adjusted to meet the special needs of older persons.

Funding source: NARI and Caulfield General Medical Centre

Year: 2005-06 (current)

Summary: Pain is the cardinal symptom of injury and disease and the leading cause for seeking medical attention. This ongoing series of experiments is examining the physiological reasons for age-related alterations in pain perception and report using experimental models of clinical pain in human volunteers. Some of our more recent findings include an ageing effect on pain thresholds that is dependent on the duration of noxious stimulation. Two groups of subjects (young & old) were stimulated with contact heat and electrical currents at three levels of stimulus duration to determine pain thresholds. There was a significant interaction between the effects of age and stimulus duration on pain thresholds for both modalities. Age-related increases in pain thresholds were more pronounced when thermal and electrical stimuli were of shorter duration. Endogenous analgesic systems are known to be important in the modulation of clinical pain states and so we recently investigated age-related differences in the function of endogenous inhibition. Younger and older volunteers undertook repeated ice water immersion of the hand to elicit an endogenous analgesic response. Pain thresholds were assessed before, during, and every 5mins post (for 60min) ice water hand immersion on the ipsi- and contra-lateral sides. The findings showed that ipsilateral pain thresholds increase in both age groups during and immediately post ice water immersion (a change of 78%). However, the magnitude of the analgesic response was significantly lower in older volunteers (27%) and this was particularly true on the contralateral side (11%).

The present studies demonstrates an age-related increase in pain threshold and a decline in endogenous analgesia with older persons. This may reduce the ability of older adults to cope with severe and persistent pain states and help explain some of the observed age-related variation in pain.

Funding source: NARI and NHMRC

Summary: This project is exploring age-related differences in the acceptance of pain, stoic attitudes to pain report, beliefs about pain symptoms and effective pain treatments in chronic pain patients aged from 20-100 years. A large sample of 300 pain free community dwelling older persons and 420 patients from several multidisciplinary pain management clinics were interviewed using standardised psychological questionnaires. To date, findings reveal that older adults are more stoic than their younger counterparts and that stoicism has been shown to affect the willingness to report pain as well as influence coping strategy use and adjustment to persistent pain. Other pain attitudes also vary as a function of age and highlight the importance of cognitive beliefs in shaping the pain experience.

Summary: We examined the psychological and physiological reasons for age-related alterations in pain perception and report using experimental models of clinical pain in human volunteers. Some of our more recent findings include an ageing effect on pain thresholds that is dependent on the duration of noxious stimulation. Furthermore, we found that the temporal summation of pain intensity ratings occurs at slower stimulation frequencies in older people. These findings emphasise the primary role of C fibre inputs in temporal summation processes and may also suggest some important age-related change in the plasticity of central nervous system mechanisms. Our studies also demonstrate a concurrent age-related decline in endogenous analgesia with older persons and this may reduce the ability of older adults to cope with severe and persistent pain states.

Summary: This project aims to explore age-related differences in the acceptance of pain, stoic attitudes to pain report, beliefs about pain symptoms and effective pain treatments in chronic pain patients aged from 20-100 years. A large sample of 300+ patients from several multidisciplinary pain management clinics are being interviewed using standardized psychological questionnaires.

Summary: This research is aimed at developing a better understanding of the similarities and differences in the chronic pain experience across the adult life span. All patients attending the NARI/MECRS pain clinic and the Caulfield pain management clinic provide questionnaire information on admission to the clinic. All data can then be compared in groups defined by age.