Dementia and response to pain in the elderly
| Autor: | Cynthia Wolf, John C. Morris, Kristen M. Malhotra, J. Philip Miller, Marcia C. Smith, Fran Lang Porter |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Video Recording Anxiety Central nervous system disease Alzheimer Disease Heart Rate Heart rate Humans Medicine Dementia Community Health Services Vagal tone Aged Demography Pain Measurement Aged 80 and over Venipuncture business.industry Cognition medicine.disease Nursing Homes Anesthesiology and Pain Medicine Neurology Case-Control Studies Physical therapy Female Neurology (clinical) Alzheimer's disease medicine.symptom Cognition Disorders business |
| Zdroj: | Pain. 68:413-421 |
| ISSN: | 0304-3959 |
| DOI: | 10.1016/s0304-3959(96)03210-1 |
| Popis: | To investigate the effect of dementia on response to pain, 51 community-dwelling, generally healthy, cognitively intact individualsor = 65 years old and 44 community- or nursing home-dwelling personsor = 65 years old with varying severity of dementia were studied. Cognitive status was assessed by standardized clinical evaluation and psychometric test performance. The following responses were measured before, during and after a standard venipuncture procedure: heart rate, the amplitude of respiratory sinus arrhythmia (RSA), self-reported anxiety and pain, and videotaped facial expressions. Although RSA did not differentiate procedural phases, in both samples, mean heart rate increased in the preparatory phase and decreased in the venipuncture phase. Independent of age, increasing severity of dementia was associated with blunting of physiologic response as measured by diminished heart rate increase in the preparatory phase and heart rate increase with venipuncture. Dementia significantly interfered with the subjects' ability to respond to direct questions about anxiety and pain. Those who were able to respond were relatively accurate self-assessors: higher anxiety was associated with greater magnitude heart rate responses. Facial expression was increased in demented individuals but it could not be classified by specific emotions. We conclude that dementia influences both the experience and reporting of pain in elderly individuals. |
| Databáze: | OpenAIRE |
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