Pain Prevalence Increases at the End of Life

The prevalence of pain increases rapidly in the last few months of life, regardless of the cause of death, a study in the Annals of Internal Medicine reports.


Researchers used data from the national Health and Retirement Study to examine levels of pain in some 4700 people over age 50 who died within 24 months of being interviewed about their pain levels. The participants were placed within 24 groups, according to the time span between their interviews and death.


Clinically significant pain — defined as pain of moderate or severe intensity most of the time — was present in about one quarter of the patients over the first 20 months. However, starting about 4 months before death, the prevalence of clinically significant pain began rising steadily, reaching a prevalence of about 50% in the final month of life. (The rate reached 60% among those with arthritis.)


An editorialist advises clinicians to routinely ask about clinically significant pain and be prepared to treat it.