Scherder E J A, Oosterman J M, Ooms M E, Ribbe M W, Swaab D F
Afdeling Klinische Neuropsychologie, Vrije Universiteit, van der Boechorststraat 1, 1081 BT Amsterdam.
Tijdschr Gerontol Geriatr. 2005 Jul;36(3):116-21.
Ageing increases the risk for the etiology of chronic pain and dementia. hence, the increase in the number of elderly people implies that the number of elderly with dementia suffering from chronic pain will increase as well. A key question relates to if and how patients with dementia perceive pain. the inadequateness of pain assessment, particularly in a more advanced stage, is also reflected in a decreased use of analgesics by elderly people with dementia. Insight into possible changes in pain experience as have been observed in the few available clinical studies, could be enhanced by knowledge about the neuropathology which may differ per subtype of dementia. It is striking that pain has not been examined in degenerative diseases of the central nervous system with a high risk for cognitive impairment such as Parkinson's disease and multiple sclerosis. In these disorders, pain is a prominent clinical symptom and to date it is not known whether the experience of pain will change in a stage in which patients become cognitively impaired. Finally, a number of instruments which are most appropriate to assess pain in communicative and non-communicative patients are discussed.
衰老会增加慢性疼痛和痴呆症病因的风险。因此，老年人数量的增加意味着患有慢性疼痛的老年痴呆症患者数量也会增加。一个关键问题涉及痴呆症患者是否以及如何感知疼痛。疼痛评估的不足，尤其是在疾病更晚期时，也体现在老年痴呆症患者使用镇痛药的减少上。对少数现有临床研究中观察到的疼痛体验可能变化的深入了解，可通过了解不同痴呆症亚型可能不同的神经病理学知识来加强。令人惊讶的是，在帕金森病和多发性硬化症等高认知障碍风险的中枢神经系统退行性疾病中，尚未对疼痛进行研究。在这些疾病中，疼痛是一个突出的临床症状，迄今为止尚不清楚在患者出现认知障碍的阶段疼痛体验是否会发生变化。最后，讨论了一些最适合评估有沟通能力和无沟通能力患者疼痛的工具。
