Depression

Persistent pain is common in older adults but tends to be underrecognized and undertreated. Up to 50% of community-dwelling older persons have significant painand up to 80% of nursing home residents have substantial pain that is undertreated.

A 65-year-old woman with a long history of hypertension treated with metoprolol and felodipine complained of dizziness, headache, nausea, and vomiting of acute onset. Her blood pressure was 220/110 mm Hg. She was drowsy and unable to stand or walk.

A 72-year-old man slipped and fell backward in the bathroom, hitting hishead on the toilet seat; he suffered only minimal discomfort. The followingday, he presented with mild back pain and extensive bruising.