After a Wreck, Older Adults Might Not Quickly Bounce Back

Car accidents may lead to persistent pain and pain medication use in older adults

(RxWiki News) Car accidents happen to people from all walks of life and at all ages. But that doesn't mean all people recover from these events as easily as others.

A new study found that many older adults who have car accidents may have persistent pain and face quality-of-life issues after the accident.

“The types of injuries that younger people recover from relatively quickly seem to put many seniors into a negative spiral of pain and disability,” said lead study author Timothy F. Platts-Mills, MD, of the University of North Carolina in Chapel Hill, in a news release.

Dr. Platts-Mills and team gathered data from eight emergency departments (EDs) in four US states between 2011 and 2014. A total of 161 patients aged 65 or older who came to the ED after a crash were identified. These adults were all sent home from the ED after being evaluated.

During follow-up interviews, Dr. Platts-Mills and team asked the patients to rate pain in areas of their body on a scale of 1 to 10. Those who were still reporting a pain score of 4 or higher six months after the accident were thought to have persistent pain.

At the time of their evaluation in the ED, 72 percent of the patients said they had moderate to severe pain. Dr. Platts-Mills and colleagues found that six months later, 26 percent of these older adults were still having moderate to severe pain related to the car accident.

Over half of the patients (54 percent) were still using some kind of pain-relieving medicine, such as opioids (like Oxycodone) or acetaminophen (like Tylenol).

A number of factors were tied to having persistent pain after a crash, such as the severity of the initial pain, the pain being located in the head, neck, jaw, lower back, or legs and symptoms of depression prior to the accident, Dr. Platts-Mills and team found.

Six months after the accident, having persistent pain seemed to go hand-in-hand with other health and quality-of-life issues.

Of those patients who had persistent pain, 73 percent said they had seen a decline in their physical function — the ability to do things like walk, climb stairs or carry groceries — after their accident, compared to only 36 percent of those without persistent pain.

This persistent pain group was also more likely than those without persistent pain to report new difficulties with daily living activities like bathing, dressing, eating and using the bathroom (42 percent compared to 17 percent). They were also more likely to have made a change in their living situation to get additional help (23 percent compared to 8 percent).

Many people do not go to the ED after an accident, which may have affected these findings, Dr. Platts-Mills and colleagues noted.

Dr. Platts-Mills and team said motor vehicle crashes are the second most common source of traumatic injury among older adults. They said that, as the population ages, the rate of these injuries will likely also rise.

This study was published online June 16 in the Annals of Emergency Medicine.

The National Institute on Aging funded this research. Dr. Platts-Mills and colleagues disclosed no conflicts of interest.

Review Date: 
June 17, 2015