The impact of aging on pressure pain thresholds: are men less sensitive than women also in older age?

Purpose: Men have generally demonstrated higher pressure pain thresholds (PPT) than women. However, the possible impact of aging on the gender differences in pain perception has not been fully evaluated. In this study, we aimed to investigate the gender differences in PPT over the life course, in young, middle-aged and older adults.

Methods: This cross-sectional study involved 355 pain-free healthy individuals aged 19-95 years, divided into < 45, 45-64 and ≥ 65 years age groups. PPT were measured using Fisher's algometer. Data on anthropometry, formal education and occupation were collected for each participant, and a multidimensional geriatric assessment was performed in older individuals.

Results: Lower PPT values were observed in old vs young adults (21.8 ± 8.7 N/cm vs 59.5 ± 31.6, p < 0.0001) and in women vs men (16.3 ± 6.1 vs 42.8 ± 19.6 N/cm, p = 0.0003). A significant interaction emerged between age and sex in influencing PPT (p = 0.03). Although women had lower mean PPT values than men in all age groups, such gender difference diminished with aging, from 42.8 ± 19.6 vs 59.5 ± 31.6 N/cm (p = 0.001) to 16.3 ± 6.1 vs 21.8 ± 8.7 vs N/cm (p = 0.003) in younger and older women vs men, respectively.

Conclusions: Female gender and older age are associated with lower PPT, but such gender difference seems to decrease with aging.