Gerontology Program, School of Nursing, College of Health and Human Services, University of North Carolina, Charlotte, NC, USA.
J Pain Res. 2012;5:61-70. doi: 10.2147/JPR.S29655. Epub 2012 Mar 23.
To examine if a concomitant relationship exists between cognition and pain in an elderly population residing in long-term care.
BACKGROUND/SIGNIFICANCE: Prior research has found that cognitive load mediates interpretation of a stimulus. In the presence of decreased cognitive capacity as with dementia, the relationship between cognition and increasing pain is unknown in the elderly.
Longitudinal cohort design. Data collected from the Minimum Data Set-Resident Assessment Instrument (MDS-RAI) from the 2001-2003 annual assessments of nursing home residents. A covariance model was used to evaluate the relationship between cognition and pain at three intervals.
The sample included 56,494 subjects from nursing homes across the United States, with an average age of 83 ± 8.2 years. Analysis of variance scores (ANOVAs) indicated a significant effect (P < 0.01) for pain and cognition, with protected t test revealing scores decreasing significantly with these two measures. Relative stability was found for pain and cognition over time. Greater stability was found in the cognitive measure than the pain measure. Cross-legged effects observed between cognition and pain measures were inconsistent. A concomitant relationship was not found between cognition and pain. Even though the relationship was significant at the 0.01 level, the correlations were low (r ≤ 0.08), indicating a weak association between cognition and pain.
Understanding the concomitance of pain and cognition aids in defining additional frameworks to extend models to include secondary needs, contextual factors, and resident outcomes. Cognitive decline, as with organic brain diseases, is progressive. Pain is a symptom that can be treated and reduced to improve resident quality of life. However, cognition can be used to determine the most appropriate method to assess pain in the elderly, thereby improving accuracy of pain detection in this population.
在居住在长期护理机构的老年人群体中，检查认知和疼痛之间是否存在伴随关系。
背景/意义：先前的研究发现，认知负荷会影响对刺激的解释。在认知能力下降的情况下，例如痴呆症，老年人中认知能力与疼痛加剧之间的关系尚不清楚。
采用纵向队列设计。从 2001-2003 年养老院居民的最低数据集合居民评估工具（MDS-RAI）年度评估中收集数据。使用协方差模型评估三个时间段内认知与疼痛之间的关系。
该样本包括来自美国各地养老院的 56494 名受试者，平均年龄为 83 ± 8.2 岁。方差分析（ANOVA）得分表明疼痛和认知存在显著影响（P < 0.01），保护 t 检验显示这两个指标的得分明显下降。随着时间的推移，疼痛和认知的相对稳定性得到了发现。认知测量的稳定性比疼痛测量的稳定性更高。在认知和疼痛测量之间观察到交叉腿效应不一致。认知和疼痛之间没有发现伴随关系。尽管在 0.01 水平上的关系是显著的，但相关性较低（r ≤ 0.08），表明认知和疼痛之间的关联较弱。
了解疼痛和认知的伴随关系有助于定义其他框架，以扩展模型，包括次要需求、背景因素和居民结果。认知能力下降，如有机脑疾病，是渐进的。疼痛是一种可以治疗和减轻的症状，可以改善居民的生活质量。然而，认知可以用来确定评估老年人疼痛的最合适方法，从而提高该人群疼痛检测的准确性。
