Pain treatment and quality of life: reducing depression and improving cognitive impairment.

The purpose of this study was to identify implications for the care of nursing home residents based on exploration of the relationship of depression to pain, cognitive impairment, and communication impairment in this population. A descriptive, cross-sectional, post-hoc design was used. Methods of statistical analysis included bivariate correlation coefficient calculation, stepwise multiple regression, and analysis of variance. A complex triad of cognitive impairment, pain, and depression was identified. The strength of the relationship between depression and cognitive impairment increases as cognitive impairment increases and in the presence of pain. This relationship is strongest among residents with severe cognitive impairment, severe communication impairment, and advanced age. Nurses may be able to relieve symptoms of depression in nursing home residents by using strategies based on knowledge of the resident's cognitive, communication, and pain status. Treating pain may lead to improved cognitive performance in residents who are depressed or reduced depression in residents who are cognitively impaired. The most elderly adults and adults with severe communication impairment may benefit most from these interventions.