Influence of age on perception of pain and antalgesia pharmacology

Influence of aging on pain: Although pain affects a large majority of the e lderly population living in the community and in institutions, our knowledg e of the evolution of pain experience with age is poor, Results of clinical surveys and experimental pain studies are contradictory, showing no change , an increase, or a decrease oi pain with age, Many results suggest a decre ase of pain perception with age that could be explained by peripheral and c entral neuroanatomical aging and psychological changes of the aging patient towards pain. Influence of age on the pharmacology of analgesics: Biological aging added to multiple pathologies and polymedication explains the pharmacological cha nges of analgesics. Among pharmacokinetic changes that are globally well kn own, vigilance must focus on renal excretion of anal/ gesics and their meta bolites and on the increased risk oi side-effects and drug interactions. in formation on pharmacodynamic changes of analgesics are scarce in aging pati ents who are susceptible to drugs and which demographical trend increases. Perspectives: A better fundamental knowledge of the evolution of pain with age could help to improve care in the elderly with pain, especially in very old subjects with cognitive impairment and loss of communication skills, w here pain evaluation is particularly difficult. Also, more research is need ed on the pharmacodynamics of analgesics in older subjects, with a view of a decreased iatrogenic risk, a better pain treatment and quality of life of the elderly.