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Epidemiology of pain in people with dementia living in care homes: longitudinal course, prevalence, and treatment implications

Rajkumar, Anto P.; Ballard, Clive; Fossey, Jane; Orrell, Martin; Moniz-Cook, Esme; Woods, Robert T.; Murray, Joanna; Whitaker, Rhiannon; Stafford, Jane; Knapp, Martin; Romeo, Renee; Romeo, Renée; Woodward-Carlton, Barbara; Khan, Zunera; Testad, Ingelin; Corbett, Anne

Authors

Anto P. Rajkumar

Clive Ballard

Jane Fossey

Martin Orrell

Professor Esme Moniz-Cook E.D.Moniz-Cook@hull.ac.uk
Professor of Clinical Psychology of Ageing and Dementia Care Research/ Dementia Research Work Group Lead

Robert T. Woods

Joanna Murray

Rhiannon Whitaker

Jane Stafford

Martin Knapp

Renee Romeo

Renée Romeo

Barbara Woodward-Carlton

Zunera Khan

Ingelin Testad

Anne Corbett



Abstract

Introduction: Knowledge regarding the longitudinal course, impact, or treatment implications of pain in people with dementia living in care homes is very limited. Methods: We investigated the people with dementia living in 67 care homes in London and Buckinghamshire, United Kingdom. Pain, dementia severity, neuropsychiatric symptoms, depression, agitation, and quality-of-life were measured using appropriate instruments at baseline (N ¼ 967) and after 9 months (n ¼ 629). Results: Baseline prevalence of pain was 35.3% (95% CI 32.3e38.3). Pain severity was significantly correlated with dementia severity, neuropsychiatric symptoms, depression, agitation, and quality of life at both time points. Regular treatment with analgesics significantly reduced pain severity. Pain was significantly associated with more antipsychotic prescriptions. Pain was significantly associated (OR 1.48; 95% CI 1.18e1.85) with all-cause mortality during follow-up. Conclusions: Pain is an important determinant of neuropsychiatric symptoms, mortality, quality-of-life, and antipsychotic prescriptions. Improved identification, monitoring, and treatment of pain are urgent priorities to improve the health and quality-of-life for people with dementia.

Journal Article Type Article
Publication Date May 1, 2017
Journal Journal of the American Medical Directors Association
Print ISSN 1525-8610
Electronic ISSN 1538-9375
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 18
Issue 5
Article Number ARTN 453.e1
Pages 453.e1-453.e6
APA6 Citation Rajkumar, A. P., Ballard, C., Fossey, J., Orrell, M., Moniz-Cook, E., Woods, R. T., …Corbett, A. (2017). Epidemiology of pain in people with dementia living in care homes: longitudinal course, prevalence, and treatment implications. Journal of the American Medical Directors Association, 18(5), 453.e1-453.e6. doi:10.1016/j.jamda.2017.01.024
DOI https://doi.org/10.1016/j.jamda.2017.01.024
Keywords Pain; Dementia; Analgesics; Quality of life; Mortality; Depression
Publisher URL http://www.sciencedirect.com/science/article/pii/S1525861017300713
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