{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:03:00Z","timestamp":1789534980435,"version":"build-2803163510"},"reference-count":147,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Chronic pain is highly prevalent among older adults and represents a major health challenge due to its multifactorial aetiology, association with multimorbidity and frailty, and impact on quality of life. This narrative review synthesises evidence from the last few decades addressing chronic pain in older adults, with emphasis on risk factors, underlying mechanisms, and preventive strategies. Risk factors were organised according to the Dahlgren and Whitehead \u201cRainbow model\u201d into individual, environmental, and social determinants. Individual-level factors\u2014particularly physical inactivity, abnormal body weight, poor nutrition, mental health disorders, maladaptive pain beliefs, sleep disturbance, previous surgical and postoperative pain, multimorbidity, frailty, smoking, and alcohol use\u2014were associated with pain persistence. Emerging evidence related to environmental and social determinants, including reduced nature and sunlight exposure, low socio-economic status, occupational factors, and social isolation, suggests further increased pain vulnerability. Mechanistic evidence indicates that ageing is associated with impaired descending pain modulation and increased susceptibility to peripheral and central sensitisation. Although randomised preventive trials in older adults remain scarce, converging evidence suggests that targeted lifestyle modification, early pain management, and multimodal non-pharmacological strategies may reduce progression to chronic pain. A prevention-oriented, risk-stratified approach integrating clinical care with broader public health strategies may help mitigate the growing burden of chronic pain in ageing societies.<\/jats:p>","DOI":"10.3390\/life16091515","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:29:29Z","timestamp":1789133369000},"page":"1515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Pain in Older Adults: Risk Factors and Prevention"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3434-2247","authenticated-orcid":false,"given":"Bruno Daniel","family":"Carneiro","sequence":"first","affiliation":[{"name":"Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Rheumatology Service, Unidade Local de Sa\u00fade do Alto Minho, Hospital Conde de Bertiandos, 4990-078 Ponte de Lima, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5102-6050","authenticated-orcid":false,"given":"Isabel","family":"Belo","sequence":"additional","affiliation":[{"name":"Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Torres","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar S\u00e3o Jo\u00e3o, Unidade Local de Sa\u00fade de Entre Douro e Vouga, 3700-298 S\u00e3o Jo\u00e3o da Madeira, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia Tavares","family":"Almeida","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, Unidade de Sa\u00fade Familiar Valongo, 4440-563 Valongo, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5696-1239","authenticated-orcid":false,"given":"Isaura","family":"Tavares","sequence":"additional","affiliation":[{"name":"Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health and IBMC (i3S), University of Porto, 4200-135 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","article-title":"Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)","volume":"160","author":"Treede","year":"2019","journal-title":"Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1093\/ageing\/afx192","article-title":"The Assessment of Pain in Older People: UK National Guidelines","volume":"47","author":"Schofield","year":"2018","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"h532","DOI":"10.1136\/bmj.h532","article-title":"Management of chronic pain in older adults","volume":"350","author":"Reid","year":"2015","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/00002508-200407000-00004","article-title":"A Review of Age Differences in the Neurophysiology of Nociception and the Perceptual Experience of Pain","volume":"20","author":"Gibson","year":"2004","journal-title":"Clin. 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