Skip to main content
Log in

Effective Pain Management in Patients with Dementia: Benefits Beyond Pain?

  • Current Opinion
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

This current opinion aims to provide a literature overview of the associations between pain and neuropsychiatric symptoms and the efficacy of pain management for both pain and neuropsychiatric symptoms in patients with dementia. In addition, international guidelines and recommendations for pain management have been collated, and important developing research areas are highlighted. Pain is, in general, under-recognized and undertreated in people with dementia and may therefore trigger or exacerbate neuropsychiatric symptoms. While there is an abundance of pain assessment instruments intended for people with dementia, few have been adequately tested for their feasibility, reliability and validity. In patients with dementia, vocalizations, facial expressions and body movements may be the only valid expressions of pain. Further, pain has been related to the neuropsychiatric symptoms of agitation, aggression, mood syndrome and sleep problems. Unfortunately, health personnel may misinterpret these symptoms as neuropsychiatric symptoms of dementia. A differential assessment of dementia, its presenting neuropsychiatric symptoms and the potential presence of pain is crucial to provide the correct treatment. To achieve this, use of pain assessment tools that are responsive to change and are validated for use in patients with dementia is a prerequisite. To date, there have been few studies, with inconsistent findings on the association between pain and neuropsychiatric symptoms. To ensure a better differential assessment of pain and neuropsychiatric symptoms, and consequently more accurate treatment for patients with dementia, studies with adequate statistical power and high-quality study designs, including randomized controlled trials, are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ferrell BA. The management of pain in long-term care. Clin J Pain. 2004;20:240–3.

    Article  PubMed  Google Scholar 

  2. Horgas AL, Tsai PF. Analgesic drug prescription and use in cognitively impaired nursing home residents. Nurs Res. 1998;47:235–42.

    Article  CAS  PubMed  Google Scholar 

  3. Won AB, Lapane KL, Vallow S, Schein J, Morris JN, Lipsitz LA. Persistent nonmalignant pain and analgesic prescribing patterns in elderly nursing home residents. J Am Geriatr Soc. 2004;52:867–74. doi:10.1111/j.1532-5415.2004.52251.x.

    Article  PubMed  Google Scholar 

  4. Achterberg WP, Gambassi G, Finne-Soveri H, Liperoti R, Noro A, Frijters DH, Cherubini A, Dell’aquila G, Ribbe MW. Pain in European long-term care facilities: cross-national study in Finland, Italy and the Netherlands. Pain. 2010;148:70–4. doi:10.1016/j.pain.2009.10.008.

    Article  PubMed  Google Scholar 

  5. Grimby C, Fastbom J, Forsell Y, Thorslund M, Claesson CB, Winblad B. Musculoskeletal pain and analgesic therapy in a very old population. Arch Gerontol Geriatr. 1999;29:29–43.

    Article  CAS  PubMed  Google Scholar 

  6. Husebo BS, Strand LI, Moe-Nilssen R, Husebo SB, Aarsland D, Ljunggren AE. Who suffers most? Dementia and pain in nursing home patients: a cross-sectional study. JAMDA. 2008;9:427–33.

    PubMed  Google Scholar 

  7. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21:658–68. doi:10.1097/EDE.0b013e3181e89905.

    Article  PubMed  Google Scholar 

  8. Lobbezoo F, Weijenberg RA, Scherder EJ. Topical review: orofacial pain in dementia patients. A diagnostic challenge. J Orofac Pain. 2011;25:6–14.

    PubMed  Google Scholar 

  9. Toxopeus AH, Husebo BS, Strand LI, Delwel S, van Wijk AJ, Scherder EJ, Lobbezoo F. The mouth care item of the MOBID pain scale: secondary analyses of unique video uptakes by dental professionals. Gerodontology. 2014. doi:10.1111/ger.12115.

  10. D’Agata E, Loeb MB, Mitchell SL. Challenges in assessing nursing home residents with advanced dementia for suspected urinary tract infections. J Am Geriatr Soc. 2013;61:62–6. doi:10.1111/jgs.12070.

    Article  PubMed Central  PubMed  Google Scholar 

  11. American Geriatric Society. The management of chronic pain in older persons: AGS Panel on Chronic Pain in Older Persons. American Geriatrics Society. J Am Geriatr Soc. 1998;46:635–51.

    Google Scholar 

  12. Scherder EJ, Plooij B. Assessment and management of pain, with particular emphasis on central neuropathic pain, in moderate to severe dementia. Drug Aging. 2012;29:701–6. doi:10.1007/s40266-012-0001-8.

    Article  Google Scholar 

  13. American Geriatric Society. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57:1331–46. doi:10.1111/j.1532-5415.2009.02376.x.

    Article  Google Scholar 

  14. Selbaek G, Kirkevold O, Engedal K. The course of psychiatric and behavioral symptoms and the use of psychotropic medication in patients with dementia in Norwegian nursing homes—a 12-month follow-up study. Am J Geriatr Psychiatry. 2008;16:528–36. doi:10.1097/JGP.0b013e318167ae76.

    Article  PubMed  Google Scholar 

  15. Ballard CG, Gauthier S, Cummings JL, Brodaty H, Grossberg GT, Robert P, Lyketsos CG. Management of agitation and aggression associated with Alzheimer disease. Nat Rev Neurol. 2009;5:245–55. doi:10.1038/nrneurol.2009.39.

    Article  CAS  PubMed  Google Scholar 

  16. Husebo BS, Ballard C, Cohen-Mansfield J, Seifert R, Aarsland D. The response of agitated behavior to pain management in persons with dementia. Am J Geriatr Psychiatry. 2013. doi:10.1016/j.jagp.2012.12.006.

  17. Husebo BS, Ballard C, Fritze F, Sandvik RK, Aarsland D. Efficacy of pain treatment on mood syndrome in patients with dementia: a randomized clinical trial. Int J Geriatr Psychiatry. 2014;29:828–36. doi:10.1002/gps.4063.

    Article  CAS  PubMed  Google Scholar 

  18. Husebo BS, Ballard C, Sandvik R, Nilsen OB, Aarsland D. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. Br Med J. 2011;343:d4065.

  19. Ballard C, Hanney ML, Theodoulou M, Douglas S, McShane R, Kossakowski K, Gill R, Juszczak E, Yu LM, Jacoby R. The Dementia Antipsychotic Withdrawal Trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol. 2009;8:151–7. doi:10.1016/s1474-4422(08)70295-3.

    Article  CAS  PubMed  Google Scholar 

  20. Pratt N, Roughead EE, Salter A, Ryan P. Choice of observational study design impacts on measurement of antipsychotic risks in the elderly: a systematic review. BMC Med Res Methodol. 2012;12:72. doi:10.1186/1471-2288-12-72.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Ballard C, Corbett A. Management of neuropsychiatric symptoms in people with dementia. CNS Drugs. 2010;24:729–39.

    PubMed  Google Scholar 

  22. Corbett A, Husebo BS, Malcangio M, Staniland A, Cohen-Mansfield J, Aarsland D, Ballard C. Assessment and treatment of pain in people with dementia. Nat Rev Neurol. 2012;8:264–74. doi:10.1038/nrneurol.2012.53.

    Article  CAS  PubMed  Google Scholar 

  23. Husebo BS, Ballard C, Aarsland D. Pain treatment of agitation in patients with dementia: a systematic review. Int J Geriatr Psychiatry. 2011;26:1012–8.

    Article  CAS  PubMed  Google Scholar 

  24. Husebo BS, Corbett A. Dementia: pain management in dementia—the value of proxy measures. Nat Rev Neurol. 2014. doi:10.1038/nrneurol.2014.66.

  25. Herr K. Pain assessment strategies in older patients. J Pain. 2011;12:S3–13. doi:10.1016/j.jpain.2010.11.011.

    Article  PubMed  Google Scholar 

  26. Husebo BS, Kunz M, Achterberg WP, Lobbezoo F, Kappesser J, Tudose C, Strand LI, Lautenbacher S. Pain assessment and treatment challenges in patients with dementia. Z Neuropsychol. 2012;23:237–46.

    Article  Google Scholar 

  27. Hurley AC, Volicer BJ, Hanrahan PA, Houde S, Volicer L. Assessment of discomfort in advanced Alzheimer patients. Res Nurs Health. 1992;15:369–77.

    Article  CAS  PubMed  Google Scholar 

  28. Fuchs-Lacelle S, Hadjistavropoulos T. Development and preliminary validation of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Pain Manag Nurs. 2004;5:37–49.

    Article  PubMed  Google Scholar 

  29. Feldt KS. The Checklist of Nonverbal Pain Indicators (CNPI). Pain Manag Nurs. 2000;1:13–21. doi:10.1053/jpmn.2000.5831.

    Article  CAS  PubMed  Google Scholar 

  30. Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J Am Med Dir Assoc. 2003;4:9–15.

    Article  PubMed  Google Scholar 

  31. Morello R, Jean A, Alix M, Sellin-Peres D, Fermanian J. A scale to measure pain in non-verbally communicating older patients: the EPCA-2 study of its psychometric properties. Pain. 2007;133:87–98. doi:10.1016/j.pain.2007.03.007.

    Article  PubMed  Google Scholar 

  32. Lefebvre-Chapiro S. Pain at the end of life, evaluating and preventing. Soins Gerontol. 2004;47:34–8.

    PubMed  Google Scholar 

  33. Snow AL, Weber JB, O’Malley KJ, Cody M, Beck C, Bruera E, Ashton C, Kunik ME. NOPPAIN: a nursing assistant–administered pain assessment instrument for use in dementia. Dement Geriatr Cogn Disord. 2004;17:240–6. doi:10.1159/000076446.

    Article  PubMed  Google Scholar 

  34. Kovach CR, Logan BR, Noonan PE, Schlidt AM, Smerz J, Simpson M, Wells T. Effects of the Serial Trial Intervention on discomfort and behavior of nursing home residents with dementia. Am J Alzheimers Dis Other Demen. 2006;21:147–55.

    Article  PubMed  Google Scholar 

  35. Husebø BS, Strand LI, Moe-Nilssen R, Husebø SB, Ljunggren AE. Pain in older persons with severe dementia. Psychometric properties of the Mobilization–Observation–Behaviour–Intensity–Dementia (MOBID-2) pain scale in a clinical setting. Scand J Caring Sci. 2010;24:380–91.

    Article  PubMed  Google Scholar 

  36. Achterberg WP, Pieper MJ, van Dalen-Kok AH, de Waal MW, Husebo BS, Lautenbacher S, Kunz M, Scherder EJ, Corbett A. Pain management in patients with dementia. Clin Interv Aging. 2013;8:1471–82.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  37. Corbett A, Husebo BS, Achterberg WP, Aarsland D, Erdal A, Flo E. The importance of pain management in older people with dementia. Br Med Bull. 2014;111:139–48. doi:10.1093/bmb/ldu023.

    Article  PubMed  Google Scholar 

  38. Husebo BS, Ostelo R, Strand LI. The MOBID-2 pain scale: reliability and responsiveness to pain in patients with dementia. Eur J Pain. 2014;18(10):1419–30. doi:10.1002/ejp.507.

    Article  CAS  PubMed  Google Scholar 

  39. Cohen-Mansfield J, Lipson S. The utility of pain assessment for analgesic use in persons with dementia. Pain. 2008;134:16–23. doi:10.1016/j.pain.2007.03.023.

    Article  PubMed  Google Scholar 

  40. Rat P, Jouve E, Pickering G, Donnarel L, Nguyen L, Michel M, Capriz-Ribiere F, Lefebvre-Chapiro S, Gauquelin F, Bonin-Guillaume S. Validation of an acute pain–behavior scale for older persons with inability to communicate verbally: Algoplus®. Eur J Pain. 2011;15:198.e1–.e10. doi:10.1016/j.ejpain.2010.06.012.

  41. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. QoL Res. 2010;19:539–49.

    Google Scholar 

  42. Husebo BS, Strand LI, Moe-Nilssen R, Husebo SB, Snow AL, Ljunggren AE. Mobilization–Observation–Behavior–Intensity–Dementia Pain Scale (MOBID): development and validation of a nurse-administered pain assessment tool for use in dementia. J Pain Symptom Manag. 2007;34:67–80.

    Article  Google Scholar 

  43. Husebø BS, Strand LI, Moe-Nilssen R, Husebø SB, Ljunggren AE. Pain behaviour and pain intensity in older persons with severe dementia: reliability of the MOBID pain scale by video uptake. Scand J Caring Sci. 2009;23:180–9.

    Article  PubMed  Google Scholar 

  44. Pieper MJC, van Dalen-Kok AH, Francke AL, van der Steen JT, Scherder EJA, Husebo BS, Achterberg WP. Interventions targeting pain or behaviour in dementia: a systematic review. Ageing Res Rev. 2013;12:1042–55. doi:http://dx.doi.org/10.1016/j.arr.2013.05.002.

  45. Zuidema S, Koopmans R, Verhey F. Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. J Geriatr Psychiatry Neurol. 2007;20:41–9. doi:10.1177/0891988706292762.

    Article  PubMed  Google Scholar 

  46. Aalten P, de Vugt ME, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FR. Behavioral problems in dementia: a factor analysis of the Neuropsychiatric Inventory. Dement Geriatr Cogn Disord. 2003;15:99–105. doi:10.1159/000067972.

  47. Hollingworth P, Hamshere ML, Moskvina V, Dowzell K, Moore PJ, Foy C, Archer N, Lynch A, Lovestone S, Brayne C, Rubinsztein DC, Lawlor B, Gill M, Owen MJ, Williams J. Four components describe behavioral symptoms in 1,120 individuals with late-onset Alzheimer’s disease. J Am Geriatr Soc. 2006;54:1348–54. doi:10.1111/j.1532-5415.2006.00854.x.

    Article  PubMed  Google Scholar 

  48. Wetzels RB, Zuidema SU, de Jonghe JF, Verhey FR, Koopmans RT. Course of neuropsychiatric symptoms in residents with dementia in nursing homes over 2-year period. Am J Geriatr Psychiatry. 2010;18:1054–65.

    Article  PubMed  Google Scholar 

  49. Selbaek G, Engedal K, Bergh S. The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. J Am Med Dir Assoc. 2013;14:161–9. doi:10.1016/j.jamda.2012.09.027.

    Article  PubMed  Google Scholar 

  50. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48:10S–6S.

    Article  Google Scholar 

  51. Cohen-Mansfield J, Libin A. Assessment of agitation in elderly patients with dementia: correlations between informant rating and direct observation. Int J Geriatr Psychiatry. 2004;19:881–91. doi:10.1002/gps.1171.

    Article  PubMed  Google Scholar 

  52. Kunik ME, Snow AL, Davila JA, Steele AB, Balasubramanyam V, Doody RS, Schulz PE, Kalavar JS, Morgan RO. Causes of aggressive behavior in patients with dementia. J Clin Psychiatry. 2010;71:1145–52. doi:10.4088/JCP.08m04703oli.

    Article  PubMed  Google Scholar 

  53. Cohen-Mansfield J, Werner P. Predictors of aggressive behaviors: a longitudinal study in senior day care centers. J Gerontol B Psychol Sci Soc Sci. 1998;53:P300–10.

    Article  CAS  PubMed  Google Scholar 

  54. Rabinowitz J, Davidson M, De Deyn PP, Katz I, Brodaty H, Cohen-Mansfield J. Factor analysis of the Cohen-Mansfield Agitation Inventory in three large samples of nursing home patients with dementia and behavioral disturbance. Am J Geriatr Psychiatry. 2005;13:991–8. doi:10.1176/appi.ajgp.13.11.991.

    Article  PubMed  Google Scholar 

  55. Morgan RO, Sail KR, Snow AL, Davila JA, Fouladi NN, Kunik ME. Modeling causes of aggressive behavior in patients with dementia. Gerontologist. 2013;53:738–47. doi:10.1093/geront/gns129.

    Article  PubMed  Google Scholar 

  56. Chopra K, Arora V. An intricate relationship between pain and depression: clinical correlates, coactivation factors and therapeutic targets. Expert Opin Ther Targets. 2014;18:159–76. doi:10.1517/14728222.2014.855720.

    Article  PubMed  Google Scholar 

  57. Cohen-Mansfield J, Taylor L. The relationship between depressed affect, pain and cognitive function: a cross-sectional analysis of two elderly populations. Aging Mental Health. 1998;2:313–8.

    Article  Google Scholar 

  58. Ferrell BA, Ferrell BR, Osterweil D. Pain in the nursing home. J Am Geriatr Soc. 1990;38:409–14.

    CAS  PubMed  Google Scholar 

  59. Won A, Lapane K, Gambassi G, Bernabei R, Mor V, Lipsitz LA. Correlates and management of nonmalignant pain in the nursing home. SAGE Study Group. Systematic Assessment of Geriatric Drug Use via Epidemiology. J Am Geriatr Soc. 1999;47:936–42.

    CAS  PubMed  Google Scholar 

  60. Walid MS, Zaytseva N. Pain in nursing home residents and correlation with neuropsychiatric disorders. Pain Physician. 2009;12:877–80.

    PubMed  Google Scholar 

  61. Giron MS, Forsell Y, Bernsten C, Thorslund M, Winblad B, Fastbom J. Sleep problems in a very old population: drug use and clinical correlates. J Gerontol A Biol Sci Med Sci. 2002;57:M236–40.

    Article  PubMed  Google Scholar 

  62. Tosato M, Lukas A, van der Roest HG, Danese P, Antocicco M, Finne-Soveri H, Nikolaus T, Landi F, Bernabei R, Onder G. Association of pain with behavioral and psychiatric symptoms among nursing home residents with cognitive impairment: results from the SHELTER study. Pain. 2012;153:305–10. doi:10.1016/j.pain.2011.10.007.

    Article  PubMed  Google Scholar 

  63. Ahn H, Horgas A. The relationship between pain and disruptive behaviors in nursing home residents with dementia. BMC Geriatr. 2013;13:14. doi:10.1186/1471-2318-13-14.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Lethem J, Slade PD, Troup JD, Bentley G. Outline of a fear-avoidance model of exaggerated pain perception. Behav Res Ther. 1983;21:401–8.

    Article  CAS  PubMed  Google Scholar 

  65. Black BS, Finucane T, Baker A, Loreck D, Blass D, Fogarty L, Phillips H, Hovanec L, Steele C, Rabins PV. Health problems and correlates of pain in nursing home residents with advanced dementia. Alzheimer Dis Assoc Disord. 2006;20:283–90. doi:10.1097/01.wad.0000213854.04861.cc.

    Article  PubMed  Google Scholar 

  66. Volicer L, Frijters DH, Van der Steen JT. Relationship between symptoms of depression and agitation in nursing home residents with dementia. Int J Geriatr Psychiatry. 2012;27:749–54. doi:10.1002/gps.2800.

    Article  PubMed  Google Scholar 

  67. Douzjian MWC, Shultz M, Berger J, Tapnio J. A program to use pain control medication to reduce psychotropic drug use in residents with difficult behavior. Ann Long Term Care. 1998;6:174–9.

    Google Scholar 

  68. Kovach CR, Noonan PE, Griffie J, Muchka S, Weissman DE. Use of the Assessment of Discomfort in Dementia protocol. Appl Nurs Res. 2001;14:193–200. doi:10.1053/apnr.2001.26784.

    Article  CAS  PubMed  Google Scholar 

  69. Brummel-Smith K, London MR, Drew N, Krulewitch H, Singer C, Hanson L. Outcomes of pain in frail older adults with dementia. J Am Geriatr Soc. 2002;50:1847–51.

    Article  PubMed  Google Scholar 

  70. Chibnall JT, Tait RC, Harman B, Luebbert RA. Effect of acetaminophen on behavior, well-being, and psychotropic medication use in nursing home residents with moderate-to-severe dementia. J Am Geriatr Soc. 2005;53:1921–9. doi:10.1111/j.1532-5415.2005.53572.x.

    Article  PubMed  Google Scholar 

  71. Sandvik R, Selbaek G, Seifert R, Aarsland D, Ballard C, Corbett A, Husebo B. Impact of a stepwise protocol for treating pain on pain intensity in nursing home patients with dementia: a cluster randomized trial. Eur J Pain. 2014;18(10):1490–500.

  72. Allen RS, Thorn BE, Fisher SE, Gerstle J, Quarles K, Bourgeois MS, Dijkstra K, Burgio LD. Prescription and dosage of analgesic medication in relation to resident behaviors in the nursing home. J Am Geriatr Soc. 2003;51:534–8.

    Article  PubMed Central  PubMed  Google Scholar 

  73. Manfredi PL, Breuer B, Wallenstein S, Stegmann M, Bottomley G, Libow L. Opioid treatment for agitation in patients with advanced dementia. Int J Geriatr Psychiatry. 2003;18:700–5. doi:10.1002/gps.906.

    Article  PubMed  Google Scholar 

  74. Abdulla A, Adams N, Bone M, Elliott AM, Gaffin J, Jones D, Knaggs R, Martin D, Sampson L, Schofield P. Guidance on the management of pain in older people. Age Ageing. 2013;42(Suppl 1):i1–57. doi:10.1093/ageing/afs200.

    Article  PubMed  Google Scholar 

  75. McLachlan AJ, Bath S, Naganathan V, Hilmer SN, Le Couteur DG, Gibson SJ, Blyth FM. Clinical pharmacology of analgesic medicines in older people: impact of frailty and cognitive impairment. Br J Clin Pharmacol. 2011;71:351–64. doi:10.1111/j.1365-2125.2010.03847.x.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  76. American Geriatric Society. The management of persistent pain in older persons. J Am Geriatr Soc. 2002;50:S205–24.

    Article  Google Scholar 

  77. Kersten H, Molden E, Tolo IK, Skovlund E, Engedal K, Wyller TB. Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2013;68:271–8. doi:10.1093/gerona/gls176.

    Article  CAS  PubMed  Google Scholar 

  78. Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I, Schubert CC, Munger S, Fick D, Miller D, Gulati R. The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging. 2009;4:225–33.

    PubMed Central  PubMed  Google Scholar 

  79. Duran CE, Azermai M, Vander Stichele RH. Systematic review of anticholinergic risk scales in older adults. Eur J Clin Pharmacol. 2013;69:1485–96. doi:10.1007/s00228-013-1499-3.

    Article  CAS  PubMed  Google Scholar 

  80. Tune LE. Anticholinergic effects of medication in elderly patients. J Clin Psychiatry. 2001;62(Suppl 21):11–4.

    CAS  PubMed  Google Scholar 

  81. Kersten H, Wyller TB. Anticholinergic drug burden in older people’s brain—how well is it measured? Basic Clin Pharmacol Toxicol. 2014;114:151–9. doi:10.1111/bcpt.12140.

    Article  CAS  PubMed  Google Scholar 

  82. Lovheim H, Karlsson S, Gustafson Y. The use of central nervous system drugs and analgesics among very old people with and without dementia. Pharmacoepidemiol Drug Saf. 2008;17:912–8. doi:10.1002/pds.1600.

    Article  PubMed  Google Scholar 

  83. Haasum Y, Fastbom J, Fratiglioni L, Kareholt I, Johnell K. Pain treatment in elderly persons with and without dementia: a population-based study of institutionalized and home-dwelling elderly. Drug Aging. 2011;28:283–93. doi:10.2165/11587040-000000000-00000.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank the G.C. Rieber Foundation for supporting our work at the Centre for Elderly and Nursing Home Medicine, University of Bergen, Norway.

E.F. and B.S.H. are members of the EU-COST-Action TD 1005: Pain Assessment in Patients with Cognitive Impairment, especially Dementia.

E.F. and C.G. have received a postdoctoral grant and a PhD grant, respectively, from the Norwegian Research Council.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elisabeth Flo.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Flo, E., Gulla, C. & Husebo, B.S. Effective Pain Management in Patients with Dementia: Benefits Beyond Pain?. Drugs Aging 31, 863–871 (2014). https://doi.org/10.1007/s40266-014-0222-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40266-014-0222-0

Keywords

Navigation