Epidemiology of Pain in People With Dementia Living in Care Homes: Longitudinal Course, Prevalence, and Treatment Implications

J Am Med Dir Assoc. 2017 May 1;18(5):453.e1-453.e6. doi: 10.1016/j.jamda.2017.01.024. Epub 2017 Mar 18.

Abstract

Introduction: Knowledge regarding the longitudinal course, impact, or treatment implications of pain in people with dementia living in care homes is very limited.

Methods: We investigated the people with dementia living in 67 care homes in London and Buckinghamshire, United Kingdom. Pain, dementia severity, neuropsychiatric symptoms, depression, agitation, and quality-of-life were measured using appropriate instruments at baseline (N = 967) and after 9 months (n = 629).

Results: Baseline prevalence of pain was 35.3% (95% CI 32.3-38.3). Pain severity was significantly correlated with dementia severity, neuropsychiatric symptoms, depression, agitation, and quality of life at both time points. Regular treatment with analgesics significantly reduced pain severity. Pain was significantly associated with more antipsychotic prescriptions. Pain was significantly associated (OR 1.48; 95% CI 1.18-1.85) with all-cause mortality during follow-up.

Conclusions: Pain is an important determinant of neuropsychiatric symptoms, mortality, quality-of-life, and antipsychotic prescriptions. Improved identification, monitoring, and treatment of pain are urgent priorities to improve the health and quality-of-life for people with dementia.

Keywords: Pain; analgesics; dementia; depression; mortality; quality of life.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use*
  • Dementia*
  • Female
  • Homes for the Aged*
  • Humans
  • London / epidemiology
  • Male
  • Pain / drug therapy*
  • Pain / epidemiology*
  • Pain / physiopathology
  • Prevalence
  • Quality of Life

Substances

  • Analgesics