Pain of ageing

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As part of a growing focus on how New Zealanders can age well, Professor David Baxter is investigating the impact of pain and its associated disabilities on older people's lives.

New Zealanders are increasingly living longer lives and most are enjoying better health. But 50 per cent of us are still likely to find our final years hampered by disability and pain.

Almost one in four New Zealanders is expected to be over 65 within the next 20 years. The statistic is reflected worldwide, meaning the challenges faced by ageing populations are a rapidly growing global phenomenon.

Now Professor David Baxter (Physiotherapy) has secured Lottery funding to investigate Ageing and Pain, researching pain-related disabilities in older adults and discovering what can be done to counter these.

Baxter is director of the Ageing Well National Science Challenge. National Science Challenges provide targeted funding for science-based research that could have major and enduring benefits for New Zealand.

Ageing Well aims to enable all New Zealanders to reach their full potential through the life course with particular reference to the latter years, helping them to retain independence and social connections, and working to develop age-friendly environments.

The University of Otago hosts two of the Ministry's person-centred challenges. Baxter runs Ageing Well and Human Nutrition's Professor Jim Mann directs the Healthier Lives challenge which aims to reduce the burden of major New Zealand health problems.

“The government has established 11 challenges since 2014, looking at the big issues that face the country in a range of areas where science can help provide answers,” says Baxter. “The fact that two of these challenges are being hosted at Otago underscores the strength of health research here, and its connections both nationally and internationally.

“Across the challenges we have multiple players and engagements, and our researchers work with long-standing national and international collaborators.

“On a national scale, for example, Otago is using cutting-edge science led by Professor John Reynolds to look at treatment for stroke patients, while Professor Valery Feigin's group at Auckland University of Technology is looking at stroke prevention.”

The Ageing Well research portfolio ranges from a large nationwide randomised trial to small pilot investigations, with nine projects launched in 2015 and five more in 2016, following a call for research on ageing in Māori and Pacific Islands populations.

“People are working together in new ways and there is a high level of community engagement. For our contestable funding call, we focused on the challenges facing Pasifica and Māori communities and, so far, we've had a lot of positive feedback.”

Another successful project, led by Dr Hamish Jamieson and Professor Sally Keeling at University of Otago, Christchurch, has been working with the International Resident Assessment Instrument (interRAI), an international collaborative programme monitoring the quality of life of vulnerable persons and helping planners match services more closely with needs.

“This initial work with interRAI is already paying huge dividends and it's pleasing to see the team has now received its own project grant from the Health Research Council.”

Baxter's Ageing and Pain research addresses a vital part of the Ageing Well mission, trying to understand the pain-related impact on older people's activity and social participation.

This includes reviewing current interventions aimed at reducing pain, exploring older people's attitudes and beliefs in regard to chronic pain, and working with local and international organisations to see how research findings can be applied to improve the quality of lives.

Long-term goals include promoting healthy ageing and providing direction for community-based programmes to reduce pain-related disability in older people.

“For most people, pain is associated with injury as a normal part of recovery. The injury heals and the pain goes away. But, for a percentage of people, pain does not go away and becomes chronic, lasting for months or even years. There may be a series of episodes of recurrence of pain or you may have painful arthritis, which is a lifelong condition.

“Pain can be compounded as people get older and the ageing process means the likelihood of chronic pain increases. For some retired people there may not be the same drivers to get back to work, or pain may actually drive people out of work.

“Medical science has advanced to the point where people no longer die as they used to from causes such as infectious diseases. Across the world people are living longer than ever before, but their life-course trajectory varies enormously compared with the ideal.

“Ageing occurs across a lifetime, not when a person turns 65. For example, a healthier, better start to life is important, as are health behaviours like avoiding obvious pitfalls such as sitting around all day and harmful drinking.

"We want to encourage the things people can do to age well and get that message across better, in terms that everyone should be able to understand."

“We've already been very active with social media, and engaging with health professionals and key stakeholders such as Age Concern. Based on this, when we have new information and new discoveries to share we can communicate them quickly.”

At a local level, the Ageing and Pain study asks Otago and Southland people about their experiences of pain, how it affects them, what barriers it creates and what could be done to help.

“We want to address levels of intervention and get appropriate guidance to health-care professionals for better patient support and management. For example, doctors used to advise long-standing rheumatoid arthritis sufferers to take it easy – but patients often read that as they shouldn't be doing anything.

“In reality, even those who suffer chronic illness need to stay as physically active as they can because it's the best they can do to keep ageing well. Current evidence shows that, while medication is important, keeping physically active is essential.

“Chronic pain limits all kinds of things and has a profound impact on the person affected, but the message still remains: if at all possible, stay active.”

Funding