Abstract
Background Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran. Objectives This study, therefore, set out to reveal the prevalence of pain, especially neuropathic type and explore its associated comorbidities among Iranian older adults in a large urban population-based survey. Methods 5326 older people, aged ≥ 60 years, were randomly chosen by a multistage, cluster sampling method. The selected people then were interviewed by using the following instruments: a standard questionnaire about pain, questions of interview part of Douleur Neuropathique 4 Questions (DN4) and its comorbidities, GHQ-28, and a sociodemographic checklist. Descriptive statistics and multiple regression analysis were conducted to analyze the gathered data. Results The average of the participants' age was 68.92 ± 7.02 years. Of 5326 participants, 2529 (47.5%) of participants were male. About one-third of this population had chronic pain. Chronic neuropathic pain prevalence was 13.7% and nociceptive in 30%. Knee pain (20.6%) and feet dysesthesia (7.8%) were the most common sites of nociceptive and neuropathic pain, respectively. Results of multiple regression analysis revealed that the major comorbidities of chronic pain were osteoporosis, disability, diabetes mellitus, and stroke. Neuropathic pain experiences were significantly associated with GHQ-28 scores (t=-11.42, P<0.001). Conclusions In addition to neuropathic pain, other subtypes of pain prevalence and the comorbidities are determined in the community-dwelling elder adults. This study highlights the importance of neuropathic pain and its adverse consequences and can be used to manage this populations' needs in Iran effectively.
Highlights
Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran
Pain can be classified according to its pathophysiology into nociceptive pain, neuropathic pain, and pain without a known somatic background [2]
Neuropathic pain is a result of damage to the nervous system, but the nociceptive pain is a result of injury to nonneural tissues when nociceptors are activated [3]
Summary
Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran. This study, set out to reveal the prevalence of pain, especially neuropathic type and explore its associated comorbidities among Iranian older adults in a large urban population-based survey. 5326 older people, aged ≥ 60 years, were randomly chosen by a multistage, cluster sampling method. Chronic neuropathic pain prevalence was 13.7% and nociceptive in 30%. Results of multiple regression analysis revealed that the major comorbidities of chronic pain were osteoporosis, disability, diabetes mellitus, and stroke. In population-based studies, neuropathic pain has been more severe than other types of pain [4,5,6], and it is important to identify patients with neuropathic pain and neuropathic components because conventional analgesic treatment may be less effective in older adults [7, 8]. Older people are a specific population for researchers and clinicians who deal with pain; as their prognosis is often less favorable, their independence is gradually lost and too much comorbidities [11, 12]
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