# CAPSITE:  Community Assessment of Pain and Sensitization in the Elderly

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2020 · $697,663

## Abstract

Chronic pain affects over 100 million American adults and >40% of older adults age ≥65, with estimated costs
of >$500 billion to $1 trillion annually. Older adults are at increased risk of having multiple painful conditions and
are living longer with the negative impacts of chronic pain. Chronic pain, regardless of anatomy or diagnosis
involved (e.g., back pain, migraine), is the leading cause of disability worldwide. Limited insights into whether
common mechanisms underlie all pain conditions, regardless of diagnosis, has contributed to inadequate pain
management options, and in turn, to the opioid epidemic. Health care providers who treat one pain condition
(e.g., joint pain) typically do not manage symptoms in other parts of the body (e.g., abdominal pain), and patients
are often referred from one specialist to another. Studying commonalities of various chronic overlapping pain
conditions (COPC) in community-based cohorts unselected for pain conditions can provide novel insights into
causes and consequences of chronic pain as a disease itself. For example, neurophysiologic alterations in pain
processing such as pain sensitization (assessing ascending pain pathways) and conditioned pain modulation
(CPM) (assessing descending pain modulation) may be common mechanisms underlying all chronic pain. Such
knowledge would spur development of novel pain management approaches for all types of pain regardless of
anatomy or diagnosis involved. Despite the substantial public health burden of chronic pain, little is known about
the epidemiology and evolution of COPC in older adults, nor of the impact of COPC on physical function, risk of
nursing home admission, and mortality in older adults. We propose to evaluate chronic pain in the upcoming
study visit of a thoroughly-characterized community-based older adult cohort unselected for any pain complaints,
the Framingham Heart Study (FHS) (N~1874, mean age 76, 84% ≥age 70). We aim to understand the
epidemiology of COPC, regardless of anatomy or diagnosis involved, the evolution of COPC over time,
neurophysiologic alterations in pain processing as risk factors for COPC and its evolution, and consequences of
COPC and altered pain processing in older adults. We propose acquiring objective quantitative sensory testing
(QST) measures of pain sensitization and CPM, which are associated with pain severity and response to
treatment in experimental settings of subjects selected for particular pain conditions. However, whether QST-
assessed neurophysiologic alterations may be common underlying risk factors for all forms of chronic pain, and
for functional limitations, institutionalization, and mortality in a community-based cohort of older adults unselected
for pain is unknown. We will collect data regarding a multitude of chronic pain conditions, QST, self-report and
performance-based physical function, and nursing home admissions during the next planned study visit, as well
as two follow-up assessments to obtain longi...

## Key facts

- **NIH application ID:** 9862154
- **Project number:** 1R01AG066010-01
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Emelia J. Benjamin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $697,663
- **Award type:** 1
- **Project period:** 2020-01-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9862154

## Citation

> US National Institutes of Health, RePORTER application 9862154, CAPSITE:  Community Assessment of Pain and Sensitization in the Elderly (1R01AG066010-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9862154. Licensed CC0.

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