Correspondence  |   December 2017
In Reply
Author Notes
  • Osaki Citizen Hospital, Furukawahonami, Osaki, Miyagi, Japan (Y.K.).
  • (Accepted for publication September 11, 2017.)
    (Accepted for publication September 11, 2017.)×
Article Information
Correspondence   |   December 2017
In Reply
Anesthesiology 12 2017, Vol.127, 1039. doi:10.1097/ALN.0000000000001910
Anesthesiology 12 2017, Vol.127, 1039. doi:10.1097/ALN.0000000000001910
Drs. Venkata, Upadhyay, and Talari expressed concern about our assessment of pain in elderly patients, assuming their limited ability to self-report. We agree that lack of precise evaluation of cognitive function of participants at baseline is a limitation of the present study. However, we excluded persons who already had been certified as disabled, by the Long-term Care Insurance information, at the start of the follow-up; therefore, all analytic subjects were considered to be capable of fully understanding the questionnaire and making valid and reliable responses.1 
We evaluated the severity of pain using a verbal rating scale (VRS). Studies comparing various pain intensity scales showed that VRS and simple numeric rating scale (NRS) have the highest validity and reliability in rating pain intensity in older adults, even in those with mild cognitive impairment.2,3  In 2007, VRS and NRS also were recommended as the best scales for guidance on the assessment of pain in elderly people by the British Pain Society and British Geriatrics Society.4 
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