In the fourth article of a series on treatment for chronic lower back pain, Carley et al. present an algorithm they have developed for physicians to both assess and treat depression in older adults with chronic lower back pain (CLBP). A number of studies suggest that depression is very common in older adults, and may heighten not only the severity of CLBP, but also the extent to which it is disabling. Employing a modified Delphi Technique, expertise from a panel of geriatricians, psychiatrists and primary care physicians was developed into a treatment plan for older adults with CLBP who may have comorbid depression. Additionally, the researchers concluded that primary care physicians should screen for depression in older adults with CLBP. Because depression in older adults with CLBP may accompany other comorbid psychiatric issues, ranging from alcoholism to anxiety disorders or dementia, the algorithm stresses a multidisciplinary approach to treating depression in older adults with pain, where cognitive behavioral therapy can be implemented in tandem with "first line" pharmacological treatments for depression. Ultimately, patients in this population will likely benefit when pain is not treated in isolation from psychiatric issues like depression. 

Degenerative joint diseases like osteoarthritis are prevalent among older adults. While exercise is often recommended to patients as a strategy for pain management, land-based exercises may place strain on joints, exacerbating symptoms. Alternatively, pool-based, aquatic exercise reduces the amount of strain placed on joints and may play a pain management role for older adults with osteoarthritis. In a recent article published in the Therapeutic Recreation Journal, researchers reviewed literature on aquatic exercise and osteoarthritic pain in older adults. In all five interventional studies reviewed, researchers found that aquatic exercise decreased pain. Additionally, one study found that aquatic exercise decreased pain-related disability and three of the five interventions found that it increased quality of life. However, because the benefits from aquatic exercise may not be sustained over a longer period of time, aquatic exercise might be best suited as one component of a multidisciplinary approach to pain management. The authors suggest that recreational therapists should implement programs of exercise three times a week and stress the importance of safety measures for older adults (e.g., handrails, non-slip surfaces), noting that high intensity aerobics in warm water may be contraindicated in individuals with cardiopulmonary disorders. 

Date: Friday, January 22, 2016

Time: 12:00 PM - 1:30 PM

Location: Call 212-746-7362

Monthly TRIPLL Work in Progress (WIP) seminars are primarily devoted to reviewing and critiquing grant proposals prior to submission. Seminars serve as a "mini-study section," where proposals are carefully reviewed in advance by seminar attendees and interdisciplinary feedback is given to the presenter. Presenters circulate their materials one week in advance of the seminar to allow group members to carefully review the work. WIP seminars have helped enhance the grant-writing skills of investigators who have gone on to obtain federal and nonfederal funding. If you are interested in learning more about our WIP Seminars, please contact Zachary Goodman at [email protected].

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NIH/NIA

Funding Amount: Variable

Due Date: Standard dates apply, by 5:00 PM local time of applicant organization.

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NIA funded Edward R. Roybal Center with a focus on persistent pain due to both cancer and non-cancer related causes. TRIPLL is a collaboration between investigators at Weill Cornell Medical College, Cornell University in Ithaca and The Hebrew Home at Riverdale.