Evaluating Pain in Different Dementia Sub types, Mild Cognitive Impairment, and Subjective Cognitive Impairment

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Evaluating Pain in Different Dementia Sub types, Mild Cognitive Impairment, and Subjective Cognitive Impairment
Key Take-Away: 

Every person experiences pain differently, even for the same cause. Identification of pain becomes more difficult among cognitively impaired individuals. The study features the pain prevalence and intensity among classes of impaired cognitive disorders and reports that pain prevalence in patients with mild to a moderate alzheimer disease (AD) and mixed AD and vascular pathology (MD) was higher than patients with  subjective cognitive impairment (SCI).

This cross-sectional study was conducted at outpatient memory clinics to assess the incidence and intensity of pain, and use of medication in pain in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI).

ABSTRACT: 
Background: 

This cross-sectional study was conducted at outpatient memory clinics to assess the incidence and intensity of pain, and use of medication in pain in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI).

A total of 759 patients with Alzheimer’s disease (AD), vascular dementia, mixed AD and vascular pathology (MD), frontotemporal dementia, dementia with Lewy Bodies, MCI, or SCI were included in the study.

 

Methods: 

For each group, self-reported presence and intensity of pain, prescribed medication, and related descriptive variables were given.

Logistic regression analyses were balanced for age, gender, and mood to compare groups on the prevalence of pain. Kruskal-Wallis test was used to test the differences in pain intensity and chi-square analyses were used to test the differences in analgesic use.

Results: 

The incidence of pain ranged from 34% in MD to 50% in SCI. The possiblity to report pain was significantly less with the AD (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.34–0.93) and MD (OR = 0.45, CI = 0.20–0.98) patients as compared to SCI patients.

There was no difference in the self-reported pain intensity between groups.  A total of 62.5% patients did not use any analgesic despite being in pain, which did not differ noteably between the groups.

Conclusion: 

The possibility to report pain is less with mild to moderate AD and MD patients in comparison to the patients with SCI. There was no difference in self-reported pain intensity. The high portion of patients with and without dementia who do not use analgesics despite being in pain raises the question if pain treatment is adequate in older patients.

 

Source:

Pain Med pnx162.

Link to the source:

https://academic.oup.com/painmedicine/article-abstract/doi/10.1093/pm/pnx162/3977944/Pain-in-Patients-with-Different-Dementia-Subtypes?redirectedFrom=fulltext

The original title of the article:

Pain in Patients with Different Dementia Subtypes, Mild Cognitive Impairment, and Subjective Cognitive Impairment

Authors:

Tarik T. Binnekade et al.

Exploratory, Alzheimer's Disease, Brain, Cross-Sectional Study, Kruskall-Wallis Test, Chi-Square Analyses
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