The Painful Truth: Interpretation of Facial Expressions of Pain in Older Adults

The purpose of this study was to determine whether it is more difficult to decode facial expressions of pain in older than in younger adults. The facial expressions of 10 younger and 10 older chronic pain patients undergoing a painful diagnostic test were viewed on videotape by untrained judges. Judges estimated the severity of pain being experienced by the patients. Ratings made of the older faces during painful moments described more pain, and appeared more accurate, than those made of younger faces. Judges also reported seeing more pain in posed, masked, and baseline facial expressions in the older adults. Age-related structural changes to the face were not responsible for this bias. This suggests that judges were predisposed to see pain in the faces of the older patients, and undermines the assumption that their ratings of pain in the painful moment segments were accurate.