Musculoskeletal pain and analgesic therapy in a very old population

The aim of this study was to examine the prevalence of musculoskeletal pain and use of analgesic drugs in a population of very old people. The investigation is based on data from the Kungsholmen project. Of the 2638 inhabitants aged 75 or more in a parish of central Stockholm 1800 were examined. Of the subjects. 60% reported trouble with pain at musculoskeletal locations, while only 40% of the pain reporting subjects used analgesics, one third of which were non-prescription minor analgesics. Prescription analgesics (non-steroidal antiinflammatory drugs or centrally acting drugs) were used by one fourth of the pain reporting subjects, and taken on a regular basis in only half of the cases. Potent opioids were used by less than 1% of the population. There was no increase in pain with increasing age, but an increase in use of minor analgesics with age >85. Women more often reported pain and had a higher consumption of analgesics. Light opioids were more often used by subjects with multifocal pain. Subjects living in sheltered accommodation used more analgesics, particularly light opioids, than did those living in their own homes or in institutions. Subjects with low or intermediate educational status more often reported pain and used light opioids to a larger extent than did the highly educated. These results indicate that musculoskeletal pain is relatively common among the very old, but does not seem to be a severe problem for the majority, considering the low proportion of subjects using prescription analgesics regularly. However, the very low use of potent opioids indicates that some of the elderly suffering from cancer and other severe pain causing diseases might be undertreated.