Correspondence  |   December 2017
Pain as a Predictor of Disability in Elderly Population
Author Notes
  • Henry Ford Hospital, Detroit, Michigan (H.G.V.). hgandam1@hfhs.org
  • (Accepted for publication September 8, 2017.)
    (Accepted for publication September 8, 2017.)×
Article Information
Correspondence
Correspondence   |   December 2017
Pain as a Predictor of Disability in Elderly Population
Anesthesiology 12 2017, Vol.127, 1038-1039. doi:10.1097/ALN.0000000000001909
Anesthesiology 12 2017, Vol.127, 1038-1039. doi:10.1097/ALN.0000000000001909
We would like to congratulate Kaiho et al. for their study published in the April 2017 issue. The study results showed that moderate-to-severe pain is significantly associated with a future risk of functional disability in patients with joint pain and/or fractures. The authors administered a cogent questionnaire to a significant sample size of the elderly population and then compared their findings to data from the Long-term Care Insurance database.1 
In this study, it is interesting to note that pain severity was positively associated with disability due to joint pain and/or fractures, yet there was a negative association with disability due to dementia and no significant association with stroke. The authors administered a questionnaire to assess pain in all study participants; however, pain in conditions such as dementia and stroke often is underestimated and undertreated owing to the limited ability of patients with these disease states to self-report.2  Healthcare providers may need specialized skills, tools, and training to assess the severity of pain in patients with moderate-to-severe dementia.2,3  The authors did not mention how pain was assessed in this subset of patients. Self-reporting should be used whenever it is appropriate, but behavior assessment tools are recommended in patients with advanced dementia.4,5 
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