Background & Aims
Ageism is common among older adults in the United States (U.S.) [1]. Initial qualitative work reveals that ageism may influence older adults’ willingness to seek pain care [2]. However, no studies have comprehensively assessed the experience and impact of ageism on U.S. older adults with chronic pain.
Methods
A sample of 1,296 community-dwelling older adults (age ?65) with chronic pain was recruited from the AmeriSpeak® Panel. AmeriSpeak, which is funded and operated by NORC at the University of Chicago, is a probability-based panel designed to be representative of the U.S. population. To assess the experience of ageism, participants completed the Ageism Survey [3], which includes five items that assess whether different experiences have occurred (e.g., “Someone assumed I could not hear well because of my age”). Participants reported the types of pharmacologic and non-pharmacologic pain management approaches they used in the past 3 months, barriers to pain treatment, and self-efficacy for pain management. Using SAS 9.4 (SAS Institute, Inc, Cary, NC), nationally representative estimates were generated by incorporating the survey design weights.
Results
An estimated 57% of older adults with chronic pain reported at least one experience of ageism. Specifically, 45.1% said a doctor or nurse assumed their ailments were caused by age; 22.8% said someone had told them “you’re too old for that”; 19.7% said someone assumed they could not hear well because of their age; 16.6% said someone assumed they could not understand because of their age; and 3.7% reported being denied medical treatment due to their age. Greater experiences of ageism were associated with a lower odds of using several nonpharmacologic pain treatments, including psychotherapy (OR=0.86, 95% CI: .74-.99) and massage (OR=0.92, 95% CI: .86-.99). Greater experiences of ageism were also associated with more barriers to pain management, including being unsure of where to get professional care, problems with traveling to appointments, not being able to afford care, and concerns about available treatments (all p<.01), and with lower pain self-efficacy (p=.001).
Conclusions
More than half of U.S. older adults with chronic pain reported experiences of ageism. Greater experiences of ageism were associated with lower odds of using certain evidence-based nonpharmacological pain management approaches (e.g., psychotherapy, massage), greater barriers to pain treatment, and lower confidence in one’s ability to manage pain. Collectively, these findings suggest that ageism warrants attention as a potential barrier to successful chronic pain management in older adults. Although additional research is needed to explore the longer-term impact of ageism on chronic pain outcomes, the current findings underscore the need to develop and improve access to effective chronic pain management strategies for older adults.
References
[1] Allen JO, Solway E, Kirch M, Singer D, Kullgren JT, Moïse V, Malani PN. Experiences of everyday ageism and the health of older US adults. JAMA Netw Open 2022;5(6):e2217240-e2217240.
[2] Makris UE, Higashi RT, Marks EG, Fraenkel L, Sale JE, Gill TM, Reid MC. Ageism, negative attitudes, and competing co-morbidities–why older adults may not seek care for restricting back pain: A qualitative study. BMC Geriatr 2015;15:1-9.
[3] Palmore E. The ageism survey: First findings. Gerontologist 2001;41(5):572-575.
Presenting Author
Lisa R. LaRowe
Poster Authors
Topics
- Pain in Special Populations: Elderly