Treating pain in patients with dementia and the possible concomitant relief of symptoms of agitation

Pain Manag. 2019 Nov;9(6):569-582. doi: 10.2217/pmt-2019-0024. Epub 2019 Nov 22.

Abstract

Dementia is an irreversible, progressive form of cognitive dysfunction that can affect memory, learning ability, thinking, orientation, comprehension, calculation, linguistic skills and executive function but which does not impair consciousness. Pain prevalence is high among the elderly who are also at elevated risk for dementia. Pain control for dementia patients is important but can be challenging for clinicians as cognitive deficits can make it difficult to identify, localize and assess pain. Cerebral changes associated with dementia may change how people process and experience pain in ways that are not entirely elucidated. Agitation is a frequent symptom of dementia and may be associated with untreated pain as agitation and aggression symptoms decrease when pain is effectively addressed.

Keywords: Alzheimer’s disease; analgesia; dementia; opioids; pain; pain assessment; pain treatment.

Publication types

  • Review

MeSH terms

  • Aggression
  • Analgesics, Opioid / therapeutic use
  • Dementia / complications*
  • Dementia / psychology*
  • Humans
  • Pain / complications
  • Pain / drug therapy*
  • Pain Management*
  • Psychomotor Agitation / complications
  • Psychomotor Agitation / drug therapy*
  • Treatment Outcome

Substances

  • Analgesics, Opioid