Prevalence of Pain in Nursing Home Residents: The Role of Dementia Stage and Dementia Subtypes.
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.
['van Kooten|Janine|J|', 'Smalbrugge|Martin|M|', 'van der Wouden|Johannes C|JC|', 'Stek|Max L|ML|', 'Hertogh|Cees M P M|CMPM|']
D000368:Aged D000369:Aged, 80 and over D003430:Cross-Sectional Studies D003704:Dementia D005260:Female D006801:Humans D008297:Male D009426:Netherlands D009735:Nursing Homes D010146:Pain D015995:Prevalence D057566:Self Report D012720:Severity of Illness Index
pain Nursing homes Dementia vascular dementia Alzheimer disease neuropathic pain