Laboratory of Geriatrics, Department of Palliative Medicine, Poznan University of Medical Sciences, Poznań, Poland.
Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland.
Clin Interv Aging. 2018 May 25;13:1045-1051. doi: 10.2147/CIA.S157246. eCollection 2018.
In patients with dementia, observational scales are recommended for use in the assessment of pain. Unfortunately, their application is rare, and as a consequence pain is frequently underdiagnosed and undertreated in these types of subjects. Thus, the aim of the study was to assess analgesic treatment in nursing home residents with cognitive impairment and to delineate the relationship between pain and behavioral and psychological symptoms of dementia.
The research was conducted in 2 nursing home facilities in Wielkopolska, Poland. The analyzed group consisted of 96 residents (78 female) with moderate and severe cognitive impairment in whom pain was assessed with the Abbey Pain Scale (APS) and agitation with the Cohen-Mansfield Agitation Inventory (CMAI). Thereafter, medical files related to drug prescriptions were analyzed.
Analgesics were consumed by 33 individuals (34%); 24 (25%) received regular pain treatment and 7 individuals (7%) - as when needed pain treatment. A relationship was found between the APS and CMAI (=0.45, <0.0001). Subjects with a higher CMAI received sedative drugs more frequently (<0.001), and despite having a higher APS (=0.001), this did not correlate with higher analgesia.
Our study suggests that pain can be an important underlying cause of behavioral disturbances in older subjects with dementia. In order to reduce their frequency and to avoid excessive usage of sedatives, proper pain assessment and management are essential.
在痴呆患者中，推荐使用观察量表来评估疼痛。然而，这些量表的应用非常罕见，因此这些患者的疼痛常常被漏诊和治疗不足。因此，本研究旨在评估认知障碍的养老院居民的镇痛治疗，并阐明疼痛与行为和心理症状的痴呆之间的关系。
该研究在波兰大波兰省的 2 家养老院进行。分析组包括 96 名（78 名女性）认知功能中度和重度受损的居民，他们的疼痛用 Abbey 疼痛量表（APS）和 Cohen-Mansfield 激越量表（CMAI）进行评估。然后，分析了与药物处方相关的医疗记录。
33 名患者（34%）接受了镇痛治疗；24 名（25%）接受常规疼痛治疗，7 名（7%）接受按需疼痛治疗。APS 和 CMAI 之间存在相关性（=0.45，<0.0001）。CMAI 较高的患者更频繁地接受镇静药物（<0.001），尽管 APS 较高（=0.001），但这与较高的镇痛效果无关。
我们的研究表明，疼痛可能是老年痴呆患者行为障碍的一个重要潜在原因。为了减少其发生频率并避免过度使用镇静剂，进行适当的疼痛评估和管理至关重要。
