Mustafa Atee1, Thomas Morris2, Stephen Macfarlane3, Colm Cunningham4. 1. The Dementia Centre, HammondCare, Wembley, Western Australia, Australia; Faculty of Health Sciences, School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia, Australia. Electronic address: matee@dementia.com.au. 2. The Dementia Centre, HammondCare, St Leonards, New South Wales, Australia. 3. The Dementia Centre, HammondCare, St Leonards, New South Wales, Australia; Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia. 4. The Dementia Centre, HammondCare, St Leonards, New South Wales, Australia; School of Public Health & Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Abstract
CONTEXT: Pain is linked to behaviors and psychological symptoms of dementia (BPSD); however, it often remains underrecognized in this population. OBJECTIVES: We aimed to investigate the prevalence and intensity of pain in people living in aged care homes with BPSD and by dementia subtypes and the association between pain intensity and BPSD. METHODS: A 1-year retrospective cross-sectional analysis was conducted on BPSD and the presence of pain in referrals to a national BPSD support service using the Neuropsychiatric Inventory and PainChek®, respectively. Referrals were categorized into two groups: pain group and no pain group. RESULTS: Of the 479 referrals (81.9 ± 8.3 years old) included in the analysis, two-thirds (65.6%) had pain identified, with almost half (48.4%) of these categorized as experiencing moderate-severe pain. Pain was highly prevalent (range: 54.6-78.6%) in all subtypes of dementia, particularly in mixed dementia and dementia with Lewy bodies. Compared with the no pain group, the pain group had 25.3% more neuropsychiatric behaviors, 33.6% higher total severity of these behaviors, and 31.4% higher total distress caused to caregivers. For all results, effect sizes were small to medium (η²p = 0.04-0.06). Despite a high prevalence of aggressive or agitated behaviors across the entire group, the pain group was 3.8 times more likely to experience these behaviors than referrals not in pain. CONCLUSION: There is a strong need to consider the possibility of pain as a contributor to behavioral changes in aged care residents living with dementia.
CONTEXT: Pain is linked to behaviors and psychological symptoms of dementia (BPSD); however, it often remains underrecognized in this population. OBJECTIVES: We aimed to investigate the prevalence and intensity of pain in people living in aged care homes with BPSD and by dementia subtypes and the association between pain intensity and BPSD. METHODS: A 1-year retrospective cross-sectional analysis was conducted on BPSD and the presence of pain in referrals to a national BPSD support service using the Neuropsychiatric Inventory and PainChek®, respectively. Referrals were categorized into two groups: pain group and no pain group. RESULTS: Of the 479 referrals (81.9 ± 8.3 years old) included in the analysis, two-thirds (65.6%) had pain identified, with almost half (48.4%) of these categorized as experiencing moderate-severe pain. Pain was highly prevalent (range: 54.6-78.6%) in all subtypes of dementia, particularly in mixed dementia and dementia with Lewy bodies. Compared with the no pain group, the pain group had 25.3% more neuropsychiatric behaviors, 33.6% higher total severity of these behaviors, and 31.4% higher total distress caused to caregivers. For all results, effect sizes were small to medium (η²p = 0.04-0.06). Despite a high prevalence of aggressive or agitated behaviors across the entire group, the pain group was 3.8 times more likely to experience these behaviors than referrals not in pain. CONCLUSION: There is a strong need to consider the possibility of pain as a contributor to behavioral changes in aged care residents living with dementia.
Authors: Rosemary Saunders; Kate Crookes; Karla Seaman; Seng Giap Marcus Ang; Caroline Bulsara; Max K Bulsara; Beverley Ewens; Olivia Gallagher; Renee M Graham; Karen Gullick; Sue Haydon; Jeff Hughes; Mustafa Atee; Kim-Huong Nguyen; Bev O'Connell; Debra Scaini; Christopher Etherton-Beer Journal: BMJ Open Date: 2022-06-20 Impact factor: 3.006