Are Chronic Pain Patients with Dementia Being Undermedicated?

Wilco P Achterberg; Ane Erdal; Bettina S Husebo; Miriam Kunz; Stefan Lautenbacher

doi:10.2147/JPR.S239321

Are Chronic Pain Patients with Dementia Being Undermedicated?

J Pain Res. 2021 Feb 15:14:431-439. doi: 10.2147/JPR.S239321. eCollection 2021.

Authors

Wilco P Achterberg¹, Ane Erdal², Bettina S Husebo², Miriam Kunz³, Stefan Lautenbacher⁴

Affiliations

¹ Department of Public Health and Primary Care, Leiden University Medical Center, RC Leiden, 2300, the Netherlands.
² Department of Global Public Health and Primary Care, University of Bergen, Bergen, 5020, Norway.
³ Department of Medical Psychology, University of Augsburg, Augsburg, 86156, Germany.
⁴ Department of Physical Psychology, University of Bamberg, Bamberg, Germany.

Abstract

In dementia, neuropathological changes alter the perception and expression of pain. For clinicians and family members, this knowledge gap leads to difficulties in recognizing and assessing chronic pain, which may consequently result in persons with dementia receiving lower levels of pain medication compared to those without cognitive impairment. Although this situation seems to have improved in recent years, considerable geographical variation persists. Over the last decade, opioid use has received global attention as a result of overuse and the risk of addiction, while the literature on older persons with dementia actually suggests undertreatment. This review stresses the importance of reliable assessment and the regular evaluation and monitoring of symptoms in persons with dementia. Based on current evidence, we concluded that chronic pain is still undertreated in dementia.

Keywords: analgesic treatment; assessment; dementia; pain.

Publication types

Review