Pain Management Developments for Older Adults with Pain

A recent article published in Medicine addressed research gaps in the area of pain management among older adults. The author determined that, "the assessment and management of pain in this age group are poorly practiced, particularly among those with dementia." The author also found that complementary and alternative pain management therapies for older adults lacked evidence-based support, stating " there are alternative approaches such as psychological therapies and self management strategies, and adjuvant treatments such as transcutaneouselectrical nerve stimulation or acupuncture, which have a relatively small body of evidence supporting their use." 

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The Relationship Between Pain and Disruptive Behaviors in Older Adults with Dementia

In BMC Geriatrics a recent study examined the relationships between pain and disruptive behaviors among older adults with dementia. The authors analyzed the Florida state Minimum Data Set (MDS 2.0) on long-term care, which consisted of data on nursing home residents with dementia aged 65 and older. The data set was used to examine "pain, wandering, aggression, agitation, cognitive impairment, activities of daily living impairments, and demographic characteristics." The authors conclude that the relationships between pain and disruptive behaviors were influenced by specific characteristics, "pain is positively correlated with disruptive behaviors that do not involve locomotion (e.g., aggression and agitation), but negatively related to disruptive behaviors that are accompanied by locomotion (e.g., wandering)."

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A Systematic Review on Prescribing Opioids in Older People 

A systematic review published in Mauritas reviewed the "current concepts, evidence and controversies" surrounding opioid use among older adults. Articles selected for the review addressed issues of "pain assessment, screening for substance abuse potential, starting treatment, monitoring effectiveness of pain control, and managing opioid-associated side-effects." The authors determined that "the challenge of prescribing opioids in older adults is to understand the factors involved in making appropriate choices and monitoring the beneficial effects of pain relief while managing the side-effects," and that "more research is needed to validate the safety, efficacy and targeted appropriate use of opioid analgesics in older people, especially those 80-years and older."

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New Evidence and Strategies for Prescribing Opiods for Chronic Pain

The American Journal of Medicine featured a study that sought to identify new evidence and strategies for prescribing opiods for chronic pain conditions among older adults. The authors identified strategies that suggested opioid use for patients with severe back pain, recommended opioid therapy for older adults at higher risk for NSAID related adverse effects, and asked health professionals to consider opioid rotation for patients that were unresponsive to opioid therapy. The authors suggest that "opioids are not appropriate for all patients; rather, a differential diagnosis, consideration of other comorbidities, and the potential for opioid-related adverse effects and substance abuse are required to confirm the value of opioid treatment for each individual."

Pain in Aging (R01)

Program Announcement (PA) Number: PAR-10-282 

"This FOA encourages Research Project Grant (R01) applications from institutions/organizations that propose to study pain from an aging perspective, including studies of older populations, studies of age differences and age-related changes in pain processes and experiences, and studies of pain treatment and management in older adults. This FOA particularly encourages studies on 1) mechanisms and predictors of pain experience in aging, 2) development and evaluation of pain assessment tools for older adults or older model organisms, and 3) development and evaluation of pain management strategies in older adults, with particular attention to the challenges associated with treating pain in patients with multiple morbidities. Studies may address a variety of approaches and outcomes including biological (i.e., genetic, molecular, neurobiological), clinical, behavioral, psychological, and social factors.  Both animal models (especially aged animals) and human subjects are appropriate for this FOA."    

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Mayday Fund of New York
"The Mayday Fund is dedicated to alleviating the incidence, degree, and consequence of human physical pain.

The Mayday Fund's current grant-making targets are projects that result in clinical interventions to reduce the toll of physical pain, pediatric pain, pain in non-verbal populations, and pain in the context of emergency medicine. Mayday will also continue to be proactive in its commitment to promote networking between veterinary and human medicine, especially in an effort to inform measurements of pain in non-verbal populations. Finally, the trustees of the Mayday Fund wish to be nimble enough to respond as special opportunities present themselves. Grants are made only to public charities and educational institutions officially recognized as such by the IRS. The Mayday Fund concentrates its activities in the United States. On occasion, grants have been made to Canadian organizations when the project has an effect that reaches beyond Canada. Grants cannot be made to individuals."

Applications are continuous and no specified due date is applied.

Age-Related Funding

Translational Research at the Aging/Cancer Interface (TRACI) (R01)

Program Announcement (PA) Number: PA-12-136

This Funding Opportunity Announcement (FOA) encourages translational research proposals in the overlapping areas of human aging and cancer, linking basic and clinical research relevant to the care of older cancer patients through both bench-to-bedside and bedside-to-bench approaches. Ultimately, information from the research supported by this initiative should improve the health and well-being of elderly patients at risk for, or diagnosed with, cancer and decrease the functional impairment and morbidity associated with cancer in this population.    

T1 Translational Research:  Novel interventions for prevention and treatment of age-related conditions (R21)

Program Announcement (PA) Number: PAS-11-280

This funding opportunity announcement (FOA) encourages exploratory/developmental R21 research projects to accelerate the pace of development of novel therapeutics involving biologics, pharmacological and non-pharmacological approaches for preventing and treating key health issues affecting the elderly.   For the purposes of this FOA, T1 translational research on aging is defined as the application of basic and clinical biomedical findings towards the development of new strategies for prevention and treatment of age-related pathologies. For projects proposing basic research that is being conducted in animal models, the potential to treat a clinical age-related pathology must be clearly stated in the proposal.  Direct relevance of the data to a clinical aging condition must be established and clearly stated in the application.

National Science Foundation funding grant "General & Age-Related Disabilities Engineering (GARDE)"
"The General & Age Related Disabilities Engineering (GARDE) program supports research that will lead to the development of new technologies, devices, or software for persons with disabilities.  Research may be supported that is directed to the characterization, restoration, and/or substitution of human functional ability or cognition, or to the interaction of persons with disabilities and their environment.  Areas of particular recent interest are disability-related research in neuroscience/neuroengineering and rehabilitation robotics.  Emphasis is placed on significant advancement of fundamental engineering and scientific knowledge and not on incremental improvements.  Proposals should advance discovery or innovation beyond the frontiers of current knowledge in disability-related research.  Applicants are encouraged to contact the Program Director Ted Conway at [email protected], or call (703) 292-7091, prior to submitting a proposal."

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The New Investigator Awards in Alzheimer's Disease
"Funded by The Rosalinde and Arthur Gilbert Foundation and The Diane and Guilford Glazer Foundation, the major goal of this partnership program is to support important research in areas in which more scientific investigation is needed to improve the prevention, diagnosis, and treatment of Alzheimer's disease. The program will also serve to encourage junior investigators in the United States and Israel to pursue research and academic careers in the neurosciences, and Alzheimer's disease in particular. Projects in basic and translational research related to Alzheimer's disease (AD) that are clinically relevant, will be considered. Projects that focus on healthy brain aging are also considered. For one of the awards, priority may be given to an investigator with a research interest related to healthy brain aging. Areas of research could for example include learning and memory, nutrition, exercise, cardiovascular risk factors, as they relate to the brain and the aging process. The applicant must be an independent investigator with assigned independent space as assigned by the departmental chair or equivalent official, and must be within the first ten years of receiving a doctoral degree by July 1, 2011. Exceptions to the ten year rule may be requested for unusual circumstances by emailing an NIH-style bio-sketch to AFAR at [email protected] .The proposed research must be conducted at any type of not-for-profit setting in the United States or Israel."

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