To many of us, it seems the older we get, the more pain we experience. It may be due to a chronic illness or it may be a sign of the wear and tear of aging. Many older patients with common chronic conditions experience chronic pain. A recent study examined how chronic pain affected the ability of older adults to perform self-management activities, in addition to looking at how it was influenced by self-efficacy or the level of confidence in one's own ability to perform a specific task. The investigators looked at a sample of data from a nationwide survey of 543 older patients, primarily older men, with chronic health conditions. Chronic pain was defined as pain present most of the time for 6 months or more during the past year. The ability to follow self-management recommendations was found by asking respondents to rate their level of difficulty in performing three commonly recommended activities as suggested by their doctor.

More than 60% of respondents in the survey reported chronic pain. Chronic pain was significantly associated with difficulty exercising regularly and taking prescribed medications, but not with following a recommended eating plan. However, when self-efficacy was taken into account, chronic pain was no longer significantly associated with either exercise or taking medications.

Comments: As the authors reported, chronic pain is a common condition among older patients and is associated with greater reported difficulty performing certain essential self-management activities. Self-efficacy, however, plays an important role in the success of self-management. Specifically, higher self-efficacy weakened the link between chronic pain and reported difficulty exercising and taking medications. We agree with the authors that promoting self-efficacy among older adults with multiple chronic health problems is a promising strategy to improve their ability to perform self-management skills.

S.L. Krein et al. Overcoming the influence of chronic pain on older patients' difficulty with recommended self-management activities. Gerontologist, 2007;47:61-68.