Pain interference and depressive symptoms in communicative people with Alzheimer's disease: a pilot study

ABSTRACT

Objectives: To examine pain interference in verbally communicative older adults with mild to moderate Alzheimer's disease (AD) and to examine the association of pain interference with cognitive function and depressive symptoms.

Method: For this pilot study, we used a cross-sectional design to examine pain interference (Brief Pain Inventory-Short Form), cognitive function (Mini-Mental State Exam), and depressive symptoms (15-item Geriatric Depression Scale) in 52 older (≥65) communicative adults with AD who reported being free from chronic pain requiring daily analgesics.

Results: Pain was reported to interfere with general activity (13.5%), mood (13.5%), walking ability (13.5%), normal work (11.5%), enjoyment of life (11.5%), relationships with other people (9.6%), and sleep (9.6%). Pain interference was significantly positively correlated with both cognitive function (r_s = 0.46, p = 0.001) and depressive symptomology (r_s = 0.45, p = 0.001), indicating that greater reported pain interference was associated with better cognitive function and more depressive symptoms.

Conclusion: Among older people with AD who report being free from chronic pain requiring daily analgesics, 2 in 10 are at risk of pain interference and depressive symptoms. Those with better cognitive function reported more pain interference and depressive symptoms, meaning pain is likely to be under-reported as AD progresses. Clinicians should regularly assess pain interference and depressive symptoms in older persons with AD to identify pain that might be otherwise overlooked..

KEYWORDS:

• Dementia
• pain assessment
• end-of-life
• community dwelling adults with dementia

Acknowledgments

The contents are solely the responsibility of the authors and do not necessarily represent the official views of these institutions. The authors gratefully acknowledge Jessica Harbison for her assistance with manuscript preparation.

Study data were collected and managed using REDCap electronic data capture tools.

Disclosure statement

The authors declare no conflicts of interest pertaining to this manuscript.

Additional information

Funding

This work was supported by The John A. Hartford Foundation to Todd B. Monroe; Mayday Fund to Todd B. Monroe; Vanderbilt Office of Clinical and Translational Scientist Development to Todd B. Monroe; Vanderbilt Clinical and Translational Research Scholars Program to Todd B. Monroe; National Institute of Health, National Institute on Aging [grant number K23 AG046379-01A1] to Todd B. Monroe; the Vanderbilt University School of Nursing Post-Doctoral Program to Jinjiao Wang; REDCap is supported by Vanderbilt Institute for Clinical and Translational Research grant [grant number UL1 TR000011] from the National Institute of Health, National Center for Advancing Translational Sciences.