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Intro; Preface; Contents; Abbreviations; 1: Epidemiology of Pain in Older People; 1.1 Prevalence of Pain in the Aging Population; 1.2 Pain and Comorbidities; References; 2: Pathophysiology of Pain; 2.1 Definitions of Pain; 2.2 Acute Pain; 2.2.1 Peripheral Mechanisms; 2.2.1.1 Nociceptors and Primary Afferent Fibres; 2.2.1.2 Algogenic Substances Responsible for Nociceptor Sensitization; 2.2.2 Central Mechanisms: Spinal Level; 2.2.2.1 Primary Afferent Fibre Input; 2.2.2.2 Spinal Sensory Neurons; 2.2.2.3 Neurotransmitters; 2.2.3 Central Mechanisms: Supraspinal Level.
2.2.4 When Acute Pain Becomes Chronic2.2.5 Peripheral Sensitization; 2.2.6 Central Sensitization; 2.2.6.1 Induction Phase of Central Sensitization; 2.2.6.2 Maintaining Central Sensitization; 2.3 Neuropathic Pain; 2.4 Pain Modulation Mechanisms; 2.5 Opioidergic System; 2.6 Descending Inhibitory Controls from the Brainstem; 2.7 Diffuse Noxious Inhibitory Controls Induced by Nociceptive Stimulation (DNICs); 2.8 Descending Facilitatory Controls; 2.9 Age Differences in Clinical Pain States; 2.9.1 Changes in Pain Perception and Pain Thresholds with Ageing.
2.9.1.1 Changes of Clinical Pain Report in Older Age2.9.1.2 Importance of Psychosocial Factors on Pain Perception in Older Age; 2.9.2 Changes of Pathophysiology of Pain in Older Age; 2.9.2.1 Changes of Central Nervous System in Older Age: The Impact of Dementia; 2.10 Summary; References; 3: The Assessment of Pain in Older People; 3.1 Pain: A Biopsychosocial Model; 3.2 The Assessment of Pain: A Systematic Approach; 3.3 Case Descriptions of Older People and the Assessment of Pain; 3.3.1 Case 1: Older Patient with Acute Pain after a Fracture.
3.3.2 Case 2: Older Patient with Chronic Pain Due to Cancer3.3.3 Case 3: Older Patient with Cognitive Impairment Due to Dementia; 3.4 Screening; 3.5 Focused Assessment of Pain; 3.6 Pain Monitoring; 3.7 Implications for Practice, Practice Development, and Research; References; 4: Non-pharmacological Management of Pain in the Elderly; 4.1 Introduction; 4.2 Self-Management of Pain; 4.3 Distraction; 4.4 Exercise and Increase in Physical Activity; 4.5 Complementary Therapies; 4.6 Massage; 4.7 Herbal Remedies/Dietary Supplements; 4.8 Acupuncture; 4.9 Relaxation; 4.10 Guided Imagery.
4.11 Transcutaneous Electrical Nerve Stimulation4.12 Use of Temperature; 4.13 Psychological Interventions; 4.14 Mindfulness; 4.15 Cognitive Behavioural Therapy; References; 5: Pharmacological Treatment of Pain; 5.1 Introduction; 5.2 Pharmacological Changes with Aging; 5.2.1 Pharmacokinetic Changes; 5.2.2 Pharmacodynamic Changes; 5.3 Analgesics and Pain Treatment in Older Adults; 5.3.1 Acute and Chronic Pain; 5.3.2 Neuropathic Pain; 5.4 Pain Treatment and Behavioral or Psychological Symptoms; References; 6: Pain in Older Adults with Intellectual Disabilities.
2.2.4 When Acute Pain Becomes Chronic2.2.5 Peripheral Sensitization; 2.2.6 Central Sensitization; 2.2.6.1 Induction Phase of Central Sensitization; 2.2.6.2 Maintaining Central Sensitization; 2.3 Neuropathic Pain; 2.4 Pain Modulation Mechanisms; 2.5 Opioidergic System; 2.6 Descending Inhibitory Controls from the Brainstem; 2.7 Diffuse Noxious Inhibitory Controls Induced by Nociceptive Stimulation (DNICs); 2.8 Descending Facilitatory Controls; 2.9 Age Differences in Clinical Pain States; 2.9.1 Changes in Pain Perception and Pain Thresholds with Ageing.
2.9.1.1 Changes of Clinical Pain Report in Older Age2.9.1.2 Importance of Psychosocial Factors on Pain Perception in Older Age; 2.9.2 Changes of Pathophysiology of Pain in Older Age; 2.9.2.1 Changes of Central Nervous System in Older Age: The Impact of Dementia; 2.10 Summary; References; 3: The Assessment of Pain in Older People; 3.1 Pain: A Biopsychosocial Model; 3.2 The Assessment of Pain: A Systematic Approach; 3.3 Case Descriptions of Older People and the Assessment of Pain; 3.3.1 Case 1: Older Patient with Acute Pain after a Fracture.
3.3.2 Case 2: Older Patient with Chronic Pain Due to Cancer3.3.3 Case 3: Older Patient with Cognitive Impairment Due to Dementia; 3.4 Screening; 3.5 Focused Assessment of Pain; 3.6 Pain Monitoring; 3.7 Implications for Practice, Practice Development, and Research; References; 4: Non-pharmacological Management of Pain in the Elderly; 4.1 Introduction; 4.2 Self-Management of Pain; 4.3 Distraction; 4.4 Exercise and Increase in Physical Activity; 4.5 Complementary Therapies; 4.6 Massage; 4.7 Herbal Remedies/Dietary Supplements; 4.8 Acupuncture; 4.9 Relaxation; 4.10 Guided Imagery.
4.11 Transcutaneous Electrical Nerve Stimulation4.12 Use of Temperature; 4.13 Psychological Interventions; 4.14 Mindfulness; 4.15 Cognitive Behavioural Therapy; References; 5: Pharmacological Treatment of Pain; 5.1 Introduction; 5.2 Pharmacological Changes with Aging; 5.2.1 Pharmacokinetic Changes; 5.2.2 Pharmacodynamic Changes; 5.3 Analgesics and Pain Treatment in Older Adults; 5.3.1 Acute and Chronic Pain; 5.3.2 Neuropathic Pain; 5.4 Pain Treatment and Behavioral or Psychological Symptoms; References; 6: Pain in Older Adults with Intellectual Disabilities.