The Principles of Assessing the Pain of Patients with Dementia

Ailsa KR Cook, BSc
Research Fellow, Centre for Social Research on Dementia,
Department of Applied Social Science, University of Stirling, Stirling, UK.


Pain Assessment in Patients with Dementia
Pain is an important consideration when caring for patients with dementia. Being in pain leads to cognitive (e.g. poor concentration) and behavioural (e.g. apathy) symptoms, which if left untreated, exacerbate the effects of the existing cognitive impairment.1,2 Pain is also associated with increased depression amongst people with dementia, as well as increases in other behavioural disorders, such as calling out and aggression.3,4,5,6

Despite its significant negative impact, research has shown that many older people with dementia experience untreated pain.7,8,9,10 A survey of 13,625 older cancer patients living in nursing homes revealed that 26% of those with daily pain received no analgesics, and a disproportionate number of this group were cognitively impaired.7 Similarly, a review of analgesic use in nursing homes found that residents with dementia were prescribed and administered fewer analgesics than were their cognitively intact counterparts.8

If pain management in this population is to improve, it is essential that health care professionals pay more attention to the assessment of pain in patients with dementia.