Scherder Erik J A, Plooij Bart, Achterberg Wilco P, Pieper Marjoleine, Wiegersma Marije, Lobbezoo Frank, Oosterman Joukje M
Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands.
Pain Med. 2015 Mar;16(3):442-50. doi: 10.1111/pme.12637. Epub 2014 Dec 19.
In a previous study, the levels of pain reported by patients with "possible" vascular dementia (VaD) were higher than those reported by older individuals without dementia.
To examine experienced pain in patients with "probable" VaD, confirmed by brain imaging.
Observational, cross sectional.
Nursing home.
The participants were 20 nursing home residents (14 females, 6 males) who met the NINDS-AIREN criteria for "probable" VaD and 22 nursing home residents with a normal mental status (18 females, 4 males). The patients were in a mild to moderate stage of dementia. All of the participants were suffering from arthritis/arthrosis or osteoporosis. Global cognitive functioning was measured by the Mini-Mental State Examination. Pain was assessed by the Coloured Analogue Scale (CAS: original and modified version) and the Faces Pain Scale. The Geriatric Depression Scale and the Symptom Checklist-90 were used to assess mood.
The main finding was that, after controlling for mood, the pain levels indicated by patients with "probable" VaD (M = 102.32; standard deviation [SD] = 53.42) were significantly higher than those indicated by the control group (M = 59.17; SD = 38.75), only according to the CAS modified version (F[1,29]) = 5.62, P = 0.01, η2 = 0.16).
As VaD patients may experience greater pain than controls, it is essential for prescribers to be aware of the presence of this neuropathology if these patients are to receive adequate treatment.
在之前的一项研究中,“可能患有”血管性痴呆(VaD)的患者报告的疼痛程度高于无痴呆的老年人。
研究经脑成像确诊为“很可能患有”VaD的患者的疼痛体验。
观察性横断面研究。
养老院。
参与者为20名符合NINDS - AIREN标准的“很可能患有”VaD的养老院居民(14名女性,6名男性)以及22名精神状态正常的养老院居民(18名女性,4名男性)。患者处于轻度至中度痴呆阶段。所有参与者均患有关节炎/关节病或骨质疏松症。通过简易精神状态检查表测量整体认知功能。采用彩色模拟量表(CAS:原始版和修订版)和面部疼痛量表评估疼痛。使用老年抑郁量表和症状自评量表90评估情绪。
主要发现是,在控制情绪后,仅根据CAS修订版,“很可能患有”VaD的患者所表明的疼痛水平(M = 102.32;标准差[SD] = 53.42)显著高于对照组(M = 59.17;SD = 38.75)(F[1,29])= 5.62,P = 0.01,η2 = 0.16)。
由于VaD患者可能比对照组经历更强烈的疼痛,如果这些患者要接受充分治疗,开处方者必须意识到这种神经病理学情况的存在。