Pain Assessment in Elderly with Behavioral and Psychological Symptoms of Dementia
| Autor: | Giovanni Sgrò, Fausto Spadea, Michele Garo, Francesco Ceravolo, Giuseppe Andrea De Biase, Alba Malara, Francesco Praino, Vincenzo Settembrini, Vincenzo Rispoli, Serena Di Cello, Francesco Bettarini |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pain Anxiety Affect (psychology) Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Pain assessment mental disorders Severity of illness Prevalence medicine Humans Dementia Prospective Studies 030212 general & internal medicine Psychiatry Depression (differential diagnoses) Pain Measurement Aged 80 and over Psychiatric Status Rating Scales Analgesics Behavior Depression business.industry General Neuroscience General Medicine medicine.disease Long-Term Care Nursing Homes Affect nursing home Psychiatry and Mental health Clinical Psychology Long-term care Logistic Models Mood Italy Multivariate Analysis Female Self Report Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery Research Article |
| Zdroj: | Journal of Alzheimer's Disease |
| ISSN: | 1875-8908 1387-2877 |
| DOI: | 10.3233/jad-150808 |
| Popis: | Background: Pain is under-detected and undertreated in people with dementia. The present study investigates the prevalence of pain in people with dementia hospitalized in nursing homes that are members of National Association of Third Age Residences (ANASTE) Calabria, and evaluates the association among pain, mood, and behavioral and psychological symptoms of dementia (BPSD). Objective: The aim of this study is to define the prevalence of pain in people with dementia in long term care facilities using scales of self-reporting and observational tools and, particularly, to study the relationship between pain and BPSD. Methods: A prospective observational study was carried out on 233 patients. Pain assessment was performed using self-reporting tools such as the Numeric Rating Scale (NRS) for patients with slight cognitive impairment or no cognitive impairment and observational tools such as Pain Assessment In Advanced Dementia Scale (PAINAD) for patients with moderate or severe cognitive impairment. Mood was evaluated through the Cornell Scale for Depression in Dementia (CSDD) while behavioral problems were assessed through the Cohen-Mansfield Agitation Inventory (CMAI) and Neuropsychiatric Inventory (NPI). Results: Only 42.5% of patients evaluated by NRS provided a reliable answer; of these, 20.4% reported no pain. The percentage of pain evaluated by PAINAD was 51.8% . Analysis of data showed a statistically significant correlation between diagnosis of pain and depressive symptoms, assessed with CSDD (p = 0.0113), as well as by single items of NPI, such as anxiety (p = 0.0362) and irritability (p = 0.0034), and F1 profile (Aggression) of CMAI (p = 0.01). Conclusion: This study confirms that self-report alone is not sufficient to assess pain in elderly people with dementia; the observational tool is a necessary and suitable way of assessing pain in patients with cognitive impairment. If not adequately treated, chronic pain can cause depression, agitation, and aggression in patients with dementia. |
| Databáze: | OpenAIRE |
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