The Dementia Centre, HammondCare, Wembley, Western Australia, Australia; Faculty of Health Sciences, School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia, Australia.
The Dementia Centre, HammondCare, St Leonards, New South Wales, Australia.
J Pain Symptom Manage. 2021 Jun;61(6):1215-1226. doi: 10.1016/j.jpainsymman.2020.10.011. Epub 2020 Oct 14.
Pain is linked to behaviors and psychological symptoms of dementia (BPSD); however, it often remains underrecognized in this population.
We aimed to investigate the prevalence and intensity of pain in people living in aged care homes with BPSD and by dementia subtypes and the association between pain intensity and BPSD.
A 1-year retrospective cross-sectional analysis was conducted on BPSD and the presence of pain in referrals to a national BPSD support service using the Neuropsychiatric Inventory and PainChek®, respectively. Referrals were categorized into two groups: pain group and no pain group.
Of the 479 referrals (81.9 ± 8.3 years old) included in the analysis, two-thirds (65.6%) had pain identified, with almost half (48.4%) of these categorized as experiencing moderate-severe pain. Pain was highly prevalent (range: 54.6-78.6%) in all subtypes of dementia, particularly in mixed dementia and dementia with Lewy bodies. Compared with the no pain group, the pain group had 25.3% more neuropsychiatric behaviors, 33.6% higher total severity of these behaviors, and 31.4% higher total distress caused to caregivers. For all results, effect sizes were small to medium (η²p = 0.04-0.06). Despite a high prevalence of aggressive or agitated behaviors across the entire group, the pain group was 3.8 times more likely to experience these behaviors than referrals not in pain.
There is a strong need to consider the possibility of pain as a contributor to behavioral changes in aged care residents living with dementia.
疼痛与痴呆（BPSD）患者的行为和心理症状有关；然而，在这一人群中，疼痛往往仍未被识别。
我们旨在调查有 BPSD 和痴呆亚型的养老院患者疼痛的发生率和强度，以及疼痛强度与 BPSD 之间的关系。
使用神经精神病学问卷和疼痛检查表对全国 BPSD 支持服务的转介患者进行了为期 1 年的回顾性横断面分析，分别评估 BPSD 和疼痛的存在。转介被分为两组：疼痛组和无疼痛组。
在纳入分析的 479 例转介病例中（81.9±8.3 岁），有三分之二（65.6%）确定存在疼痛，其中近一半（48.4%）被归类为中重度疼痛。在所有类型的痴呆症中，疼痛的发生率都很高（范围：54.6%-78.6%），特别是在混合性痴呆症和路易体痴呆症中。与无疼痛组相比，疼痛组的神经精神行为增加了 25.3%，这些行为的总严重程度增加了 33.6%，对护理人员的总困扰增加了 31.4%。对于所有结果，效应大小为小到中等（η²p = 0.04-0.06）。尽管整个组都有很高比例的攻击性或激越行为，但疼痛组出现这些行为的可能性是无疼痛组的 3.8 倍。
有强烈的需要考虑疼痛是导致养老院痴呆患者行为变化的一个因素。
