TY - JOUR
T1 - Prevalence of Pain in Nursing Home Residents
T2 - The Role of Dementia Stage and Dementia Subtypes
AU - van Kooten, Janine
AU - Smalbrugge, Martin
AU - van der Wouden, Johannes C.
AU - Stek, Max L.
AU - Hertogh, Cees M.P.M.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Objectives To study pain prevalence, pain type, and its pharmacological treatment in Dutch nursing home residents in relation to dementia subtype and dementia severity. Design Data were collected as part of the PAINdemiA study, an observational cross-sectional study conducted between May 2014 and December 2015. Setting Ten nursing homes in the Netherlands. Participants A total of 199 nursing home residents in various stages of dementia. Measurements We collected data on pain (by observation: MOBID-2 Pain Scale and by self-report scales), pain type, pain medication, dementia subtype, dementia severity (GDS), and demographic features. Results In the whole sample, the prevalence of pain was 43% (95% confidence interval 36%–50%) using the MOBID-2 Pain Scale. Regardless of regularly scheduled analgesics, approximately one-third of the residents with pain suffered from moderate to severe pain. Pain assessment with the MOBID-2 Pain Scale showed no difference in pain between dementia subtypes, but residents with more severe dementia experienced pain more often than those with less severe dementia (27% vs 15%). The prevalence of self-reported pain was significantly higher in residents with vascular dementia (VaD) (54%) compared with those with Alzheimer disease (18%) and other dementia subtypes (14%). Nociceptive pain was the predominant type of pain (72%) followed by mixed pain (25%). Acetaminophen was the most prescribed analgesic (80%). Conclusion Most of the participating nursing home residents had no pain; however, pain was observed more often in residents with severe dementia, whereas residents in the early stages of VaD self-reported pain more often that those with other dementia subtypes. As one-third of the residents with clinically relevant pain had moderate to severe pain regardless of using pain medication, more focus should be on how pain management could use more tailored approaches and be regularly adjusted to individual needs.
AB - Objectives To study pain prevalence, pain type, and its pharmacological treatment in Dutch nursing home residents in relation to dementia subtype and dementia severity. Design Data were collected as part of the PAINdemiA study, an observational cross-sectional study conducted between May 2014 and December 2015. Setting Ten nursing homes in the Netherlands. Participants A total of 199 nursing home residents in various stages of dementia. Measurements We collected data on pain (by observation: MOBID-2 Pain Scale and by self-report scales), pain type, pain medication, dementia subtype, dementia severity (GDS), and demographic features. Results In the whole sample, the prevalence of pain was 43% (95% confidence interval 36%–50%) using the MOBID-2 Pain Scale. Regardless of regularly scheduled analgesics, approximately one-third of the residents with pain suffered from moderate to severe pain. Pain assessment with the MOBID-2 Pain Scale showed no difference in pain between dementia subtypes, but residents with more severe dementia experienced pain more often than those with less severe dementia (27% vs 15%). The prevalence of self-reported pain was significantly higher in residents with vascular dementia (VaD) (54%) compared with those with Alzheimer disease (18%) and other dementia subtypes (14%). Nociceptive pain was the predominant type of pain (72%) followed by mixed pain (25%). Acetaminophen was the most prescribed analgesic (80%). Conclusion Most of the participating nursing home residents had no pain; however, pain was observed more often in residents with severe dementia, whereas residents in the early stages of VaD self-reported pain more often that those with other dementia subtypes. As one-third of the residents with clinically relevant pain had moderate to severe pain regardless of using pain medication, more focus should be on how pain management could use more tailored approaches and be regularly adjusted to individual needs.
KW - Alzheimer disease
KW - Dementia
KW - Nursing homes
KW - neuropathic pain
KW - pain
KW - vascular dementia
UR - http://www.scopus.com/inward/record.url?scp=85013392496&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jamda.2016.12.078
DO - https://doi.org/10.1016/j.jamda.2016.12.078
M3 - Article
C2 - 28236607
SN - 1525-8610
VL - 18
SP - 522
EP - 527
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 6
ER -