Geriatrics and Gerontology Elsewhere
Published: 2016-03-15

Pain management in dementia: so far, not so good

Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy; University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy
University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy
University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy
Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy
Azienda Ospedaliera of Pavia, Voghera Hospital, Italy
Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy; University of Pavia, Department of Public Health, Experimental Medicine and Forensic, Italy
Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy
Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy; University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy
Pain Dementia Alzheimer disease Elderly Opioids

Abstract

Pain is highly prevalent in the aging population. Individuals with neurological disorders such as dementia are
susceptible patient groups in which pain is frequently under-recognised, underestimated, and under-treated.
The inability to successfully communicate pain in moderate-severe dementia is a major barrier to effective
treatment and several observational studies indicate that pain is under-treated among cognitively impaired
elderly people.
Pain has been related to neuropsychiatric symptoms in dementia, such as agitation, aggression, mood syndrome
and sleep problems. Adequate pain management has been demonstrated as possibly effective in mediating
or alleviating those symptoms.
Recent guidelines (American Geriatric Society 2009, British Geriatric Society 2013) recommend a comprehensive,
disease-specific assessment to determine appropriate treatment for each individual. Whereas in old
patients data on pain management are becoming more consistent, we still lack clinical evidence in those affected
by dementia.
In this narrative review, we summarize the best-available evidence regarding the aetiology, assessment and
treatment of pain in people with dementia. Further large-scale trials of treatment approaches in people with
dementia are needed to improve clinical guidance for the diagnosis and treatment of pain in these fragile individuals.

Affiliations

F. Guerriero

Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy; University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy

C. Sgarlata

University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy

N. Maurizi

University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy

M. Rollone

Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy

M. Carbone

Azienda Ospedaliera of Pavia, Voghera Hospital, Italy

M. Rondanelli

Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy; University of Pavia, Department of Public Health, Experimental Medicine and Forensic, Italy

S. Perna

Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy

G. Ricevuti

Agency for Elderly Services, S. Margherita Hospital, Pavia, Italy; University of Pavia Department of Internal Medicine and Therapeutics, Section of Geriatrics, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2016

How to Cite

[1]
Guerriero, F., Sgarlata, C., Maurizi, N., Rollone, M., Carbone, M., Rondanelli, M., Perna, S. and Ricevuti, G. 2016. Pain management in dementia: so far, not so good. JOURNAL OF GERONTOLOGY AND GERIATRICS. 64, 1 (Mar. 2016), 31-39.
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