Chronic pain in older adults : prevalence, incidence, and risk factors

Objectives: Chronic pain is common in older adults, yet little is known of its development and the factors that predict its persistence and onset at old age. The aims of this longitudinal cohort study were to examine the prevalence and incidence of chronic pain and to explore possible risk factors for its persistence and onset in a representative sample of older Swedish adults. Method: Data were collected through questionnaires and followed up after 12 and 24 months. Chronic pain was defined as pain symptoms that lasted more than 3 months, regardless of the specific cause or site. Logistic regression analyses were used to identify odds ratios (ORs) with 95% confidence intervals (CIs) for potential predictors. Results: Out of 2000 older adults approached (aged 65–103 years), 1141 were included in the study. Chronic pain was reported among 38.5% of the participants, and was more common among females and among adults over 85 years of age. The incidence was estimated to be 5.4% annually. Being female (OR 3.19, 95% CI 1.04–9.59), having a lower body mass index (BMI; OR 0.89, 95% CI 0.79–0.99), more than one pain location (OR 4.02, 95% CI 1.56–10.35), higher severity (OR 1.79, 95% CI 1.13–2.83), and longer duration (OR 1.08, 95% CI 1.01–1.15) were associated with the persistence of chronic pain, but this association did not remain significant for men when divided by gender. Younger age (OR 0.89, 95% CI 0.89–0.99) was associated with new onset of chronic pain. Conclusions: Even though pain was often highly prevalent and persistent, our results show that both recovery and onset of pain occurred. Pain characteristics, rather than age-related symptoms and psychosocial variables, predicted pain persistence among older women but not among older men. These findings highlight the importance of early pain management in the prevention of future pain

Fission-Track Thermochronology Applied to the Evolution of Passive Continental Margins

International audiencePassive continental margins (PCMs) form at divergent plate boundaries in response to continental breakup and subsequent formation of new oceanic basins. The onshore topography of PCMs is a key component to understand the evolution of extensional settings. The classic nomenclature of PCMs is derived from early investigations that suggested apparent tectonic stability after the initial phase of rifting and breakup. However, geological and geomorphic diversity of PCMs requires more complex models of rift and post-rift evolution. Fission-track (FT) thermochronology provides appropriate tools to decipher the long-term development of PCM topography and better resolve the spatial and temporal relationships between continental erosion and sediment accumulation in adjacent offshore basins. FT datasets have revealed complex spatial and temporal denudation histories across some PCMs and have shown that several kilometres of material may be removed from the onshore margin following rifting. Combining these data with geological and geomorphological observations, and with predictions from numerical modelling, suggests that PCMs may have experienced significant post-rift activity. Case histories illustrated in this chapter include the PCM of southeastern Africa and the conjugate PCMs of the North and South Atlantic