Editorial: Pain in Dementia: A Distressing Combination of Several Factors

Achterberg, Wilco P.; Lautenbacher, Stefan

doi:10.2174/156720501405170403224615

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Only two studies (2.8 % of all tests) report a positive correlation, with one of these studies having been conducted on patients suff ering from dementia-related cognitive impairment (Scherder et al, 2008). Given that the ability to validly report pain declines across the course of dementia (Achterberg & Lautenbacher, 2017), the positive correlation between executive functioning and reported pain intensity could be because of the more severely impaired patients not being able to give a self-report of pain.…”

Section: Discussion Executive Functioning and Chronic Painmentioning

confidence: 99%

Executive Functions and Pain

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Zuidema

et al. 2019

Zeitschrift für Neuropsychologie

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Abstract. A growing body of literature suggests that chronic-pain patients suffer from problems in various neuropsychological domains, including executive functioning. In order to better understand which components of executive functioning (inhibition, shifting and/or updating) might be especially affected by pain and which mechanisms might underlie this association, we conducted a systematic review, including both chronic-pain studies as well as experimental-pain studies. The chronic-pain studies (N = 57) show that pain is associated with poorer executive functioning. The findings of experimental-pain studies (N = 28) suggest that this might be a bidirectional relationship: Pain can disrupt executive functioning, but poorer executive functioning might also be a risk factor for higher vulnerability to pain.

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Section: Discussion Executive Functioning and Chronic Painmentioning

confidence: 99%

Executive Functions and Pain

Bunk

Preis

Zuidema

et al. 2019

Zeitschrift für Neuropsychologie

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“…However, the communication of pain presence, which is not obvious and is not understood by caregivers, is a well-known problem in dementia care 20. Different authors have reported that the prevalence of pain in dementia patients is less frequent compared to that in age-matched subjects without cognitive impairment 21. We also found huge differences in analgesic use when residents were divided according to cognitive impairment.…”

Section: Discussionmentioning

confidence: 67%

Cognitive status and use of analgesics and anxiolytics in residents of nursing homes in the Czech Republic

Holmerová

Auer

Beránková

et al. 2018

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BackgroundThe treatment of pain and treatment of anxiety are two of the most complex issues in nursing homes worldwide, mainly because of the large numbers of people with cognitive impairment who reside in this environment.AimThe aim of this study was to investigate the administration of analgesics and anxiolytics to people living in nursing homes, taking into account cognitive status.MethodsFor this cross-sectional study, we used data from 404 residents who lived in nine randomly selected nursing homes in the Czech Republic and participated in the Czech-Austrian Long-Term Care Research Project called DEMDATA. Information about medication administration was obtained from medical records. Cognitive impairment was evaluated by the Mini-Mental State Examination, and pain was measured by the Pain Assessment in Advanced Dementia. To measure anxiety, we used the Behavioral Pathology in Alzheimer’s Disease Rating Scale in residents with severe-to-moderate dementia and also the standardized questionnaire EuroQol in other residents.ResultsIn all, 68% (95% CI 62–74) of residents with pain did not receive any analgesic medication and 31% (95% CI 25–38) of residents were administered some analgesics and continued to report pain. The lowest reported occurrence of pain, as well as the lowest prevalence of analgesic administration, was in residents with moderate-to-severe dementia. We found that an alarming percentage of residents in the nursing homes were not treated sufficiently.ConclusionThis study indicates that treatment effects should be better monitored.

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“…Assessing pain in individuals with cognitive impairments can be quite challenging, given that the ability to provide a valid self-report of pain can be limited and deteriorates across the course of cognitive decline [ 1 , 2 , 3 ]. As a result, pain is often overlooked in individuals with cognitive impairments and, thus, remains undertreated [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Observing Pain in Individuals with Cognitive Impairment: A Pilot Comparison Attempt across Countries and across Different Types of Cognitive Impairment

et al. 2021

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Facial expression is a key aspect in observational scales developed to improve pain assessment in individuals with cognitive impairments. Although these scales are used internationally in individuals with different types of cognitive impairments, it is not known whether observing facial expressions of pain might differ between regions or between different types of cognitive impairments. In a pilot study, facial responses to standardized experimental pressure pain were assessed among individuals with different types of cognitive impairments (dementia, mild cognitive impairment, Huntington’s disease, and intellectual disability) from different countries (Denmark, Germany, Italy, Israel, and Spain) and were analyzed using facial descriptors from the PAIC scale (Pain Assessment in Impaired Cognition). We found high inter-rater reliability between observers from different countries. Moreover, facial responses to pain did not differ between individuals with dementia from different countries (Denmark, Germany, and Spain). However, the type of cognitive impairment had a significant impact; with individuals with intellectual disability (all being from Israel) showing the strongest facial responses. Our pilot data suggest that the country of origin does not strongly affect how pain is facially expressed or how facial responses are being scored. However, the type of cognitive impairment showed a clear effect in our pilot study, with elevated facial responses in individuals with intellectual disability.

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Editorial: Pain in Dementia: A Distressing Combination of Several Factors

Cited by 5 publications

References 14 publications

Executive Functions and Pain

Executive Functions and Pain

Cognitive status and use of analgesics and anxiolytics in residents of nursing homes in the Czech Republic

Observing Pain in Individuals with Cognitive Impairment: A Pilot Comparison Attempt across Countries and across Different Types of Cognitive Impairment

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