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老年人的疼痛与认知:现状

Pain in the elderly and cognition: state of play.

作者信息

Deleens Rodrigue, Pickering Gisèle, Hadjiat Yacine

机构信息

Centre d'évaluation et de traitement de la douleur, CHU de Rouen, France, Centre d'étude et de traitement de la douleur, Hôpital Cochin, Paris, France.

Centre de pharmacologie clinique, CHU Clermont-Ferrand, France, Inserm, CIC 1405, UMR Neurodol 1407, Clermont-Ferrand, France, Laboratoire de pharmacologie, Faculté de médecine, Clermont Université, Clermont-Ferrand, France.

出版信息

Geriatr Psychol Neuropsychiatr Vieil. 2017 Dec 1;15(4):345-356. doi: 10.1684/pnv.2017.0702.

Abstract

Cognitive impairment is commonly associated with the pain experience. This deterioration regarding several cognitive domains such as attention, speed of information processing, memory, learning and executive functions, represents a major obstacle to daily activities and mobility especially in the elderly for whom a decrease in mobility is a significant risk factor for death and disability. Regarding the demographic rising in the elderly population expected by 2050 (the proportion of persons aged 60 and above is expected to double according to ONU estimate) and the high prevalence of pain in this age reaching 80% in nursing homes, clinicians should be better aware of the links between pain and cognition in this population's segment so that they offer each patient an appropriate treatment. The objective of this review is to draw up an inventory of knowledge and differences between general population and elderly population on the complex relationship between these two phenomena, the contribution of imaging in the understanding of this link and the role of attitudes, beliefs and opioids on pain perception and cognition.

摘要

认知障碍通常与疼痛体验相关。这种在多个认知领域(如注意力、信息处理速度、记忆、学习和执行功能)的衰退,对日常活动和行动能力构成了重大障碍,尤其是在老年人中,行动能力下降是死亡和残疾的重要风险因素。鉴于预计到2050年老年人口将增加(据联合国估计,60岁及以上人口的比例预计将翻倍),且该年龄段疼痛的高患病率在养老院达到80%,临床医生应更好地了解这部分人群中疼痛与认知之间的联系,以便为每位患者提供适当的治疗。本综述的目的是梳理关于这两种现象之间复杂关系、成像在理解这种联系中的作用以及态度、信念和阿片类药物对疼痛感知和认知的作用方面,普通人群和老年人群体之间的知识和差异。

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