214
Views
0
CrossRef citations to date
0
Altmetric
Review

Treating Pain in Patients With Dementia and the Possible Concomitant Relief of Symptoms of Agitation

, , , &
Pages 569-582 | Received 18 Jun 2019, Accepted 05 Sep 2019, Published online: 22 Nov 2019

References

  • World Health Organization . Dementia. World Health Organization, Geneva, Switzerland (2017).
  • Patterson C . World Alzheimer Report 2018: the State of the Art of Dementia Research: New Frontiers. Alzheimer’s Disease International, London, UK (2018).
  • Zwakhalen SM , HamersJP , Abu-SaadHH , BergerMP. Pain in elderly people with severe dementia: a systematic review of behavioural pain assessment tools. BMC Geriatr.6, 3 (2006).
  • Binnekade TT , ScherderEJA , MaierABet.al Pain in patients with different dementia subtypes, mild cognitive impairment, and subjective cognitive impairment. Pain Med.19(5), 920–927 (2018).
  • van Kooten J , BinnekadeTT , vander Wouden JCet.al A review of pain prevalence in Alzheimer’s, vascular, frontotemporal and lewy body dementias. Dement. Geriatr. Cogn. Disord.41(3–4), 220–232 (2016).
  • Griffioen C , WillemsEG , HuseboBS , AchterbergWP. Prevalence of the use of opioids for treatment of pain in persons with a cognitive impairment compared with cognitively intact persons: a systematic review. Curr. Alzheimer Res.14(5), 512–522 (2017).
  • Tan EC , VisvanathanR , HilmerSNet.al Analgesic use and pain in residents with and without dementia in aged care facilities: a cross-sectional study. Australas. J. Ageing35(3), 180–187 (2016).
  • Closs SJ , BarrB , BriggsM. Cognitive status and analgesic provision in nursing home residents. Br. J. Gen. Pract.54(509), 919–921 (2004).
  • Sandvik R , SelbaekG , KirkevoldO , AarslandD , HuseboBS. Analgesic prescribing patterns in Norwegian nursing homes from 2000 to 2011: trend analyses of four data samples. Age Ageing45(1), 54–60 (2016).
  • Jensen-Dahm C , PalmH , GasseC , DahlJB , WaldemarG. Postoperative treatment of pain after hip fracture in elderly patients with dementia. Dement. Geriatr. Cogn. Disord.41(3–4), 181–191 (2016).
  • Del Giorno R , FrumentoP , VarrassiG , PaladiniA , CoaccioliS. Assessment of chronic pain and access to pain therapy: a cross-sectional population-based study. J. Pain Res.10, 2577–2584 (2017).
  • Leuter C , PiroliA , MarinangeliF , PaladiniA , TudiniM , VarrassiG. Care strategies and therapeutic pathways for chronic pain patients in Abruzzo region, Italy. Ann. Ing.29, 63–72 (2017).
  • Paladini A , FuscoM , CoaccioliS , SkapeS , VarrassiG. Chronic pain in the elderly: the case for new therapeutic strategies. Pain Physician18, E863–E876 (2015).
  • Carlino E , BenedettiF , RaineroIet.al Pain perception and tolerance in patients with frontotemporal dementia. Pain151(3), 783–789 (2010).
  • Achterberg WP , PieperMJ , van Dalen-KokAHet.al Pain management in patients with dementia. Clin. Interv. Aging8, 1471–1482 (2013).
  • Scherder EJ , SergeantJA , SwaabDF. Pain processing in dementia and its relation to neuropathology. Lancet Neurol.2(11), 677–686 (2003).
  • Sewards TV , SewardsMA. The medial pain system: neural representations of the motivational aspect of pain. Brain Res. Bull.59(3), 163–180 (2002).
  • Monroe TB , GoreJC , ChenLM , MionLC , CowanRL. Pain in people with Alzheimer disease: potential applications for psychophysical and neurophysiological research. J. Geriatr. Psychiatry Neurol.25(4), 240–255 (2012).
  • Monroe T , CarterM , FeldtK , TolleyB , CowanRL. Assessing advanced cancer pain in older adults with dementia at the end-of-life. J. Adv. Nurs.68(9), 2070–2078 (2012).
  • Oosterman JM , van HartenB , WeinsteinHC , ScheltensP , ScherderEJ. Pain intensity and pain affect in relation to white matter changes. Pain125(1–2), 74–81 (2006).
  • Widar M , SamuelsonL , Karlsson-TiveniusS , AhlstromG. Long-term pain conditions after a stroke. J. Rehabil. Med.34, 165–170 (2002).
  • Edelstyn N , BakerS , EllisS , JenkinsonP. A cognitive neuropsychological and psychophysioogical investigation of a patient who exhibited an acute exacerbated behavioural espone during innocous somatosensory stimulation and movement. Behav. Neurol.15, 15–22 (2004).
  • Reed B , EberlingJ , MungasD , WeinerM , KramerJ , JagustW. Effects of white matter lesions and lacunes on cortical function. Arch. Neurol.61, 1545–1550 (2004).
  • Dolcos F , LaBarK , CabezaR. Dissociable effects of arousal and valence on prefrontal activity indexing emotional evaluation and subsequent memory: an event-related fMRI study. Neuroimage23, 64–74 (2004).
  • Lagraize S , BorzanJ , PengY , FuchsP. Selective regulation of pain affect following activation of the opioid anterior cingulate cortex system. Exp. Neurol.197, 22–30 (2006).
  • Rainero I , VighettiS , BergamascoB , PinessiL , BenedettiF. Autonomic responses and pain perception in Alzheimer’s disease. Eur. J. Pain4(3), 267–274 (2000).
  • Plooij B , SwaabD , ScherderE. Autonomic responses to pain in aging and dementia. Rev. Neurosci.22(5), 583–589 (2011).
  • Cole LJ , FarrellMJ , DuffEP , BarberJB , EganGF , GibsonSJ. Pain sensitivity and fMRI pain-related brain activity in Alzheimer’s disease. Brain129(Pt 11), 2957–2965 (2006).
  • Kunz M , MyliusV , ScharmannS , SchepelmanK , LautenbacherS. Influence of dementia on multiple components of pain. Eur. J. Pain.13(3), 317–325 (2009).
  • Benedetti F , CarlinoE , PolloA. How placebos change the patient’s brain. Neuropsychopharmacology36(1), 339–354 (2011).
  • Benedetti F , ArduinoC , CostaSet.al Loss of expectation-related mechanisms in Alzheimer’s disease makes analgesic therapies less effective. Pain121(1–2), 133–144 (2006).
  • Eippert F , FinsterbuschJ , BingelU , BuchelC. Direct evidence for spinal cord involvement in placebo analgesia. Science326(5951), 404 (2009).
  • Eippert F , BingelU , SchoellEDet.al Activation of the opioidergic descending pain control system underlies placebo analgesia. Neuron63(4), 533–543 (2009).
  • Jennings AA , LinehanM , FoleyT. The knowledge and attitudes of general practitioners to the assessment and management of pain in people with dementia. BMC Fam. Pract.19(1), 166 (2018).
  • Husebo BS , StrandLI , Moe-NilssenR , HuseboSB , LjunggrenAE. Pain in older persons with severe dementia. Psychometric properties of the Mobilization-Observation-Behaviour-Intensity-Dementia (MOBID-2) pain scale in a clinical setting. Scand. J. Caring Sci.24(2), 380–391 (2010).
  • Fries B , SimonS , MorrisJ. Pain in U.S. nursing homes: validating a pain scale for the minimum data set. Gerontologist41, 173–179 (2001).
  • Pieper MJC , vander Steen JT , FranckeAL , ScherderEJA , TwiskJWR , AchterbergWP. Effects on pain of a stepwise multidisciplinary intervention (STA OP!) that targets pain and behavior in advanced dementia: a cluster randomized controlled trial. Palliat. Med.32(3), 682–692 (2018).
  • Kim YS , ParkJM , MoonYS , HanSH. Assessment of pain in the elderly: a literature review. Natl Med. J. India30(4), 203–207 (2017).
  • Herr K . Pain assessment in cognitively impaired older adults. Am. J. Nurs.102(12), 65–67 (2002).
  • Herr K . Chronic pain: challenges and assessment strategies. J. Gerontol. Nurs.28(1), 20–27 (2002).
  • Abbey J , PillerN , DeBellis Aet.al The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int. J. Palliat. Nurs.10(1), 6–13 (2004).
  • Wary B , DoloplusC. Doloplus-2, a scale for pain measurement. Soins Gerontol.19, 25–27 (1999).
  • Warden V , HurleyAC , VolicerL. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J. Am. Med. Dir. Assoc.4(1), 9–15 (2003).
  • Villanueva MR , SmithTL , EricksonJS , LeeAC , SingerCM. Pain assessment for the dementing elderly (PADE): reliability and validity of a new measure. J. Am. Med. Dir. Assoc.4(1), 1–8 (2003).
  • Fuchs-Lacelle S , HadjistavropoulosT. Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). Pain Manag. Nurs.5(1), 37–49 (2004).
  • Zuidema S , KoopmansR , VerheyF. Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. J. Geriatr. Psychiatry Neurol.20(1), 41–49 (2007).
  • Pieper MJ , van Dalen-KokAH , FranckeALet.al Interventions targeting pain or behaviour in dementia: a systematic review. Ageing Res. Rev.12(4), 1042–1055 (2013).
  • Ahn H , HorgasA. The relationship between pain and disruptive behaviors in nursing home residents with dementia. BMC Geriatr.13, 14 (2013).
  • Corbett A , HuseboB , MalcangioMet.al Assessment and treatment of pain in people with dementia. Nat. Rev. Neurol.8(5), 264–274 (2012).
  • Rajkumar AP , BallardC , FosseyJet.al Epidemiology of pain in people with dementia living in care homes: longitudinal course, prevalence, and treatment implications. J. Am. Med. Dir. Assoc.18(5), 453.e451–453.e456 (2017).
  • Centers for Medicare & Medicaid Services . National partnership to improve dementia care exceeds goal to reduce use of antipsychotic medications in nursing homes: CMS announces new goal. Press release.
  • Resnick B , KolanowskiA , Van HaitsmaKet.al Current psychotropic medication use and contributing factors among nursing home residents with cognitive impairment. Clin. Nurs. Res.1054773819838678 (2019) ( Epub ahead of print).
  • Cohen-Mansfield J , TheinK , MarxMS. Predictors of the impact of nonpharmacologic interventions for agitation in nursing home residents with advanced dementia. J. Clin. Psychiatry75(7), e666–e671 (2014).
  • Larson CK , KaoH. Hospice diagnosis: polypharmacy: a teachable moment. JAMA Intern. Med.175(11), 1750–1751 (2015).
  • Morrison RS , SiuAL. A comparison of pain and its treatment in advanced dementia and cognitively intact patients with hip fracture. J. Pain Symptom Manage.19(4), 240–248 (2000).
  • Tosato M , LukasA , vander Roest HGet.al Association of pain with behavioral and psychiatric symptoms among nursing home residents with cognitive impairment: results from the SHELTER study. Pain153(2), 305–310 (2012).
  • Habiger TF , FloE , AchterbergWP , HuseboBS. The interactive relationship between pain, psychosis, and agitation in people with dementia: results from a cluster-randomised clinical trial. Behav. Neurol.2016, 7036415 (2016).
  • Moschinski K , KuskeS , AndrichSet.al Drug-based pain management for people with dementia after hip or pelvic fractures: a systematic review. BMC Geriatr.17(1), 54 (2017).
  • Mundi S , ChaudhryH , BhandariM. Systematic review on the inclusion of patients with cognitive impairment in hip fracture trials: a missed opportunity?Can. J. Surg.57(4), E141–E145 (2014).
  • Banks WA . Drug delivery to the brain in Alzheimer’s disease: consideration of the blood–brain barrier. Adv. Drug Deliv. Rev.64(7), 629–639 (2012).
  • Montagne A , ZhaoZ , ZlokovicBV. Alzheimer’s disease: a matter of blood–brain barrier dysfunction?J. Exp. Med.214(11), 3151–3169 (2017).
  • Yamazaki Y , KanekiyoT. Blood–brain barrier dysfunction and the pathogenesis of Alzheimer’s disease. Int. J. Mol. Sci.18(9), E1965 (2017).
  • Shega JW , HoughamGW , StockingCB , Cox-HayleyD , SachsGA. Management of noncancer pain in community-dwelling persons with dementia. J. Am. Geriatr. Soc.54(12), 1892–1897 (2006).
  • Hamina A , TaipaleH , TanskanenAet.al Long-term use of opioids for nonmalignant pain among community-dwelling persons with and without Alzheimer disease in Finland: a nationwide register-based study. Pain158(2), 252–260 (2017).
  • Lovheim H , KarlssonS , GustafsonY. The use of central nervous system drugs and analgesics among very old people with and without dementia. Pharmacoepidemiol Drug Saf.17(9), 912–918 (2008).
  • Pitkala KH , JuolaAL , HosiaHet.al Eight-year trends in the use of opioids, other analgesics, and psychotropic medications among institutionalized older people in Finland. J. Am. Med. Dir. Assoc.16(11), 973–978 (2015).
  • Pergolizzi J , BogerRH , BuddKet.al Opioids and the management of chronic severe pain in the elderly: consensus statement of an international expert panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract.8(4), 287–313 (2008).
  • Jensen-Dahm C , GasseC , AstrupA , MortensenPB , WaldemarG. Frequent use of opioids in patients with dementia and nursing home residents: a study of the entire elderly population of Denmark. Alzheimers Dement.11(6), 691–699 (2015).
  • Husebo BS , BallardC , Cohen-MansfieldJ , SeifertR , AarslandD. The response of agitated behavior to pain management in persons with dementia. Am. J. Geriatr. Psychiatry22(7), 708–717 (2014).
  • Brown R , HowardR , CandyB , SampsonEL. Opioids for agitation in dementia. Cochrane Database Syst. Rev.14(5), CD009705 (2015).
  • Blytt KM , BjorvatnB , HuseboB , FloE. Effects of pain treatment on sleep in nursing home patients with dementia and depression: a multicenter placebo-controlled randomized clinical trial. Int. J. Geriatr. Psychiatry33(4), 663–670 (2018).
  • Blytt KM , HuseboB , FloE , BjorvatnB. Long-term pain treatment did not improve sleep in nursing home patients with comorbid dementia and depression: a 13-week randomized placebo-controlled trial. Front. Psychol.9, 134 (2018).
  • Hamina A , LavikainenP , TanskanenAet.al Impact of opioid initiation on antipsychotic and benzodiazepine and related drug use among persons with Alzheimer’s disease. Int. Psychogeriatr.30(7), 947–956 (2018).
  • Dhull DK , KumarA. Tramadol ameliorates behavioural, biochemical, mitochondrial and histological alterations in ICV-STZ-induced sporadic dementia of Alzheimer’s type in rats. Inflammopharmacology26(4), 925–938 (2018).
  • Griffioen C , HuseboBS , FloE , CaljouwMAA , AchterbergWP. Opioid prescription use in nursing home residents with advanced dementia. Pain Med.20(1), 50–57 (2019).
  • Fainsinger RL , WallerA , BercoviciMet.al A multicentre international study of sedation for uncontrolled symptoms in terminally ill patients. Palliat. Med.14(4), 257–265 (2000).
  • Brown R . Broadening the search for safe treatments in dementia agitation a possible role for low-dose opioids?Int. J. Geriatr. Psychiatry25(10), 1085–1086 (2010).
  • Manfredi PL , BreuerB , WallensteinS , StegmannM , BottomleyG , LibowL. Opioid treatment for agitation in patients with advanced dementia. Int. J. Geriatr. Psychiatry18(8), 700–705 (2003).
  • Dublin S , WalkerRL , GraySLet.al Prescription opioids and risk of dementia or cognitive decline: a prospective cohort study. J. Am. Geriatr. Soc.63(8), 1519–1526 (2015).
  • Park KR , KimKB , BaekYHet.al Signal detection of benzodiazepine use and risk of dementia: sequence symmetry analysis using South Korean national healthcare database. Int. J. Clin. Pharm.40(6), 1568–1576 (2018).
  • La Frenais F , StoneP , SampsonEL. Analgesic prescribing in care home residents: how epidemiological studies may inform clinical practice. Pain Manag.6(6), 561–568 (2016).
  • Husebo BS , BallardC , AarslandD. Pain treatment of agitation in patients with dementia: a systematic review. Int. J. Geriatr. Psychiatry26(10), 1012–1018 (2011).
  • Erdal A , BallardC , VahiaIV , HuseboBS. Analgesic treatments in people with dementia – how safe are they? A systematic review. Expert Opin. Drug Saf.18(6), 511–522 (2019).

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.