SPECIFICITY OF PAIN PERCEPTION AND REPORTING IN OLDER ADULTS: A RETROSPECTIVE STUDY

U. Michalik-Marcinkowska¹, D. Myrcik², G. Varrassi³ | ¹Department of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Poland; ²Department of Propaedeutics of Internal Diseases and Emergency Medicine, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Poland; ³Fondazione Paolo Procacci, Rome, Italy

Abstract

Background and Aims. Pain in older adults is frequently underreported and misinterpreted as a natural consequence of aging, potentially leading to inadequate management. An evaluation of the determinants of pain perception and reporting among older adults, with particular emphasis on psychological, cognitive, and personal factors.
Methods. A cross-sectional study was conducted in 212 adults aged ≥65 years recruited from outpatient clinics. Pain intensity was assessed using the Numerical Rating Scale, while pain characteristics were evaluated using the Brief Pain Inventory. Cognitive status was assessed using the Mini-Mental State Examination. Sociodemographic and clinical data were collected through structured interviews. Multivariable linear regression analysis was performed to identify factors associated with self-reported pain intensity, and Spearman correlation analysis was used to assess relationships between psychological variables and pain scores. Descriptive analyses were used to summarize the prevalence of chronic pain.
Results. Chronic pain was reported by 58% of participants, with higher prevalence in institutionalized individuals (76% vs. 49%, p < 0.01). Lower pain intensity was associated with male gender (β = -0.28, p = 0.02), lower catastrophizing scores (β = -0.34, p < 0.01), and reduced cognitive function (MMSE < 24; β = -0.31, p = 0.01). Higher self-efficacy was moderately correlated with lower pain intensity (r = -0.42, p < 0.001).
Conclusions. A complex interplay of psychological, cognitive, and sociocultural factors influences pain perception and reporting in older adults. Lower reported pain intensity is more common among men and individuals with cognitive impairment, which may contribute to underrecognition of pain in these groups. These findings emphasize the necessity of structured and multidimensional pain assessment strategies among people over 65.