Pain Prevalence in Dementia

The development of speech and language impairment in dementia presents barriers in many clinical domains.

One important clinical domain is assessment and management of pain. Dementia may preclude spontaneous or interview-elicited pain reporting.

A report today in MedicalXpress noted reduced reporting of pain in patients with diabetes and cognitive impairment.

I was able to locate one free full-text manuscript reviewing the prevalence of pain in various types of dementias. This literature review found the following:

• Pain prevalence was estimated at 46% of Alzheimer's disease patients
• Pain prevalence was estimated at 56% of vascular dementia patients
• Pain prevalence was estimated at 53% in mixed dementia patients
• Insufficient research study was found for determining rates of pain in frontotemporal and Lewy body dementia populations

These studies support rigorous pain assessment and monitoring for pain in dementia patient populations. Alert clinicians and nurses can aid in proxy assessment of pain when speech and language impairments reduce pain self reporting.

You can access this full text review manuscript by clicking on the PMID in the citation below.

I found a helpful education sheet produced by the Australian government on pain in dementia. This sheet included a list of potential non-verbal signs of pain in later stages of dementia including:

• Facial grimacing
• Moaning or crying out with movement
• Increased heart rate, blood pressure or sweating
• Changes in sleep patterns including increased or restless sleep
• Changes in behavior including increased irritability or aggression.

You can access the Pain and Dementia Education in the Dementia Q&A section at this link. 

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van Kooten J, Binnekade TT, van der Wouden JC, Stek ML, Scherder EJ, Husebø BS, Smalbrugge M, & Hertogh CM (2016). A Review of Pain Prevalence in Alzheimer's, Vascular, Frontotemporal and Lewy Body Dementias. Dementia and geriatric cognitive disorders, 41 (3-4), 220-32 PMID: 27160163