Pain is one of the most frequent reasons for consultations in general practice, presenting either alone or associated with some
comorbidity. In all care settings for older and oldest old patients, a gap exists between best-practice recommendations and current clinical
practice. Clinical manifestations of persistent pain are often complex and multifactorial in the frail population, so the approach to pain
management in older persons differs from that for younger people. The purpose of this review is to describe the best approach to assess
and manage persistent cancer and no-cancer pain in the elderly, to explain the principles of pain treatment in this so often frail and complex
population and compare the different drugs that should be used or avoided in older and oldest old patients considering the agerelated
physiologic changes. Considerable emphasis is placed on conditions more common in the elderly such as neuropathic pain or
typical subsets of the aging population such as the assessment of pain in people with dementia.
Keywords: Persistent pain, cancer pain, neuropathic pain, cognitive impairment, elderly, dementia.
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