Lecture 4 (older adults/gender) Flashcards Preview

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Flashcards in Lecture 4 (older adults/gender) Deck (10):

- Presence of acute pain is roughly the same across life span, but there

is an age-related increase in the prevalence of chronic pain at least until the seventh decade of life
o Limited evidence to suggest a plateau or even a slight reduction in the frequency of pain complaints beyond this age


- Recognize potential indicators of pain, such as pain behaviors, in those who are unable to report pain

(e.g., stroke, Alzheimer’s, etc.); observe these behaviors against an est. baseline or during movement


- Understand the importance of a comprehensive medical hx and physical exam when assessing older pain patient; know how to perform a

comprehensive musculoskeletal exam including that of joints, soft tissues, and the axial skeleton; know that chronic pain in older adults is often contributed to by more than one diagnosis, so comprehensive assessment should be performed routinely


- Increased likelihood of atypical pain due to diminished phys. Reserves and interacting comorbidities; high prevalence of incidental pathology (e.g., radiographic osteoarthritis in the absence of symptoms, etc.); know that the

hx and phys exams should guide acquisition of additional diagnostic studies and tests; pathway may be elusive in some with chronic pain, yet treatable/ should be recognized as a discrete entity


- Women typically report more frequent and/or severe pain than men report - All the things re. women:

o Women are at greater risk for several chronic pain disorders: temporomandibular disorder, fibro, migraines, interstitial cystitis, joint pain, IBS, complex regional pain syndrome, trigeminal neuralgia
o Greater risk for autoimmune disorders that have a pain component
o Greater procedural and postoperative pain (some studies reported no sex differences)
o Women report lower pain thresholds and tolerances
o Ratings of suprathreshold stimuli are often higher among women across a wide range of painful stimuli
o Women are more likely to seek pain-related medical care
o Women are more likely to suffer an adverse effect after analgesia


Men are at greater risk for

some pain disorders, including cluster headaches and pancreatitis


Differences vary with age and are associated with

endogenous or exogenous sex hormone changes (migraines is an example)
o Genetic factors appear to determine some sex differences in pain and analgesia


- Multiple psychosocial variables may contribute to sex differences in clinical and experimental pain responses, including (but not limited to) anxiety, abuse history, coping, gender roles, and family history

BOO! Wake up, this shit is boring.


- Wo/men presenting with pain complaints may be offered different tests/treatments

o Available evidence does not support sex-specific tailoring of treatments; however, this is a conceivable outcome in the foreseeable future


Trans adults and pain

- Trans folk are dx w/ more chronic conditions than cis folk, based on limited evidence
o True for mh conditions
- Trans adults have higher rates of hypertension, congestive heart failure, coronary artery disease, hyperlipidemia, arthritis, dementia, stroke, chronic kidney disease, and diabetes