Neuropathic pain in elderly: a multicenter study

Abstract

Introduction: Aging brings with it an increase in the prevalence of pain. For effective pain treatment, it is important to determine pain prevalence, its nature, and the factors affecting it. However, epidemiologic information on neuropathic pain in the elderly is inadequate. In our cross-sectional multicenter study, we aimed to determining the prevalence of neuropathic pain in elderly patients and the relationship of neuropathic pain with socio-demographic and clinical factors. Materials and Method: Thirteen centers in different regions of Turkey. The study included 1163 individuals over age 65. Physicians conducted face-to-face interviews to obtain clinical and socio-demographic data and The Douleur Neuropathic 4 (DN4) and The Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scales were used to assess neuropathic pain. Patients who scored >= 4 or >= 12 on the DN4 and S-LANSS scales, respectively, were determined to be experiencing neuropathic pain. Results: Neuropathic pain was found in 52.5% of the patients (n=610) in this study. Approximately 67.5% of the patients with neuropathic pain were in the 65-74 age group, and 72.1% (n=440) were females. Of the patients who were experiencing neuropathic pain, 48.4% were graduates of primary school, 91.6% engaged in very little or no physical activity, and 56.7% were taking four or more medications. Conclusions: Neuropathic pain prevalence was 52.5% in the elderly over age 65 who had presented with pain complaints. Neuropathic pain was more frequently seen in women, patients with comorbidities, those with poor levels of ambulation, those using walking aids, and those using multiple drugs. Interrogating the elderly for neuropathic pain seems important for effective treatment.

Girifl: Yafllanma ile birlikte a¤r› s›kl›¤›nda art›fl olmaktad›r. Etkin a¤r› tedavisi için a¤r› s›kl›¤› ve etkileyen faktörleri belirlemek önemlidir. Ancak yafll›larda nöropatik a¤r›n›n epidemiyolojik verisi ile ilgili bilgiler yetersizdir. Çal›flmam›zda amaç; yafll› hastalarda nöropatik a¤r› s›kl›¤›, nöropatik a¤r›n›n sosyodemografik ve klinik özellikler ile iliflkisini belirlemektir. Gereç ve Yöntem: Çal›flmaya Türkiye’nin farkl› bölgelerinden, 13 merkez fizik tedavi ve rehabilitasyon polikliniklerine a¤r› flikayeti ile baflvuran 65 yafl üstü 1163 hasta al›nd›. Klinik ve sosyodemografik veriler yüzyüze sorgulama yöntemi ile elde edildi. Hastalarda nöropatik a¤r›y› de- ¤erlendirmek için DN 4 ve S-LANSS a¤r› ölçe¤i kullan›ld›. DN4 ≥4 veya S-LANSS a¤r› ölçe¤i ≥12 üzerinde olanlarda nöropatik a¤r› oldu¤u kabul edildi. Bulgular: Çal›flmaya dahil edilenlerin %52,5’inde (n=610) nöropatik a¤r› saptand›. Hastalar›n %67,5’si 65-74 yafl aral›¤›nda ve %72,1’i (n=440) kad›nd›. Nöropatik a¤r›s› olanlar›n; %48,4’ü ilkö¤retim mezunu, %91,6’s›n›n fiziksel aktivitesi hiç yok ya da çok düflüktü, %56,7’si 4 ve üzeri ilaç kullan›yor olarak bulundu. Sonuç: A¤r› flikayeti olan 65 yafl üzeri yafll›larda nöropatik a¤r› s›kl›¤› %52,5 olarak saptand›. Kad›nlarda, komorbiditesi olanlarda ,ambulasyon düzeyi kötü olanlarda, yürümede yard›mc› cihaz kullananlarda ve çoklu ilaç kullananlarda nöropatik a¤r› daha s›k görülmekte olup yafll›lar›n nöropatik a¤r› aç›s›ndan sorgulanmas› etkin tedavi aç›s›ndan önem tafl›maktad›r.