The stages of pain processing across the adult lifespan

The purpose of this study was is to examine age-related differences in a 4-stage model of the processing of chronic pain. This study used data collected from 1585 chronic pain patients that were divided into 3 age cohorts: younger adults 18-44 years old (n = 895), middle-aged adults 45-64 years old (n = 538), older adults 65-85 years old (n = 159). Using an analyasis of covariate analysis (ANCOVA) model, mean differences across the age cohort were found on the third (emotional distress) and fourth (pain behavior) stages of the pain processing model. The older adult group reported less emotional response to pain and less pain behavior than the younger or middle-aged groups. Age cohort differences in the linear relationship between stages were tested using structural equation modeling. The middle-aged group showed the highest association between their emotional responses to pain and pain behaviors, and the older group showed the least association. No differences in magnitude or association were found for the 2 initial stages of pain processing (usual pain intensity or pain unpleasantness). These differences are likely to be a function of differences in life circumstances, attitudes and beliefs about pain and/or aging, and age cohort-related differences in the methods used for coping with chronic pain.