Tsatali Marianna, Papaliagkas Vasileios, Damigos Dimitrios, Mavreas Venetsanos, Gouva Maria, Tsolaki Magda
Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Curr Alzheimer Res. 2014;11(6):574-9. doi: 10.2174/1567205011666140618103406.
BACKGROUND/OBJECTIVES: During the next decades a rapid increase is expected in the number of patients with dementia suffering from pain who often take less medication compared to normal elderly, due to several diagnostic barriers. Comorbid mood disorders result in great difficulties in pain assessment and further treatment.
Twenty five patients with Alzheimer's disease, comorbid mood disorders, and chronic musculoskeletal pain (experimental group) and thirty one patients with Alzheimer's disease and chronic musculoskeletal pain without comorbid mood disorders (control group) were examined. The assessment tools used were Geriatric Pain Measure, Patient Health Questionnaire, Pain Assessment in Advanced Dementia, Mini Mental State Examination and Pain Anxiety Symptom Scale. Statistical analysis was performed by SPSS v17.0, using the Pearson correlation and the multiple linear regression analysis.
The correlation between mood disorders and levels of pain intensity in the experimental group was found to be statistically higher than that in the control group (p<.001). Among all quantitative variables, highly significant correlation (p<.001) was observed between stress and depression symptomatology (r =.550, p<.001) in the experimental group. Normal regression analysis was used to assess possible differences between demographic data and PASS scores. Scores in fearful thinking and physiological responses scales of PASS were higher in female than male (p=.014), whereas scores in the cognitive anxiety scale of PASS have shown a highly significant positive correlation with years of education (p<.001).
It seems that depression and anxiety are associated with chronic musculoskeletal pain intensity in dementia, thus need to be taken into consideration by health professionals for patient's management.
背景/目的：在未来几十年中，预计患有疼痛的痴呆症患者数量将迅速增加。由于多种诊断障碍，这些患者通常比正常老年人服用的药物更少。共病情绪障碍给疼痛评估和进一步治疗带来了很大困难。
对25例患有阿尔茨海默病、共病情绪障碍和慢性肌肉骨骼疼痛的患者（实验组）以及31例患有阿尔茨海默病和慢性肌肉骨骼疼痛但无共病情绪障碍的患者（对照组）进行了检查。使用的评估工具包括老年疼痛量表、患者健康问卷、晚期痴呆症疼痛评估、简易精神状态检查表和疼痛焦虑症状量表。采用SPSS v17.0进行统计分析，使用Pearson相关性分析和多元线性回归分析。
发现实验组中情绪障碍与疼痛强度水平之间的相关性在统计学上高于对照组（p<.001）。在所有定量变量中，实验组中压力与抑郁症状之间观察到高度显著的相关性（p<.001）（r =.550，p<.001）。使用正态回归分析来评估人口统计学数据和疼痛焦虑症状量表（PASS）得分之间的可能差异。PASS的恐惧思维和生理反应量表得分女性高于男性（p =.014），而PASS的认知焦虑量表得分与受教育年限呈高度显著正相关（p<.001）。
似乎抑郁和焦虑与痴呆症患者的慢性肌肉骨骼疼痛强度有关，因此健康专业人员在对患者进行管理时需要予以考虑。
