Cardiovascular risk factors in cognitively impaired nursing home patients: a relationship with pain?
Cardiovascular risk factors (CRF) such as hypertension and diabetes mellitus favour the development of both vascular dementia (VaD) and Alzheimer's disease (AD). The resulting deafferentation may increase the experience of pain in VaD and in AD. The goal of the present study was to examine the relationship between CRF and pain in a sample of 107 cognitively impaired nursing home patients who had also a chronic pain condition. The prevalence of pain in patients with hypertension or diabetes mellitus was higher (25/41=61% of them had pain) than those without diabetes or hypertension (of whom 24/66=36.4% had pain, p=0.017). In a multivariate logistic regression model (adjusted for gender, age and depression) the presence of diabetes or hypertension was a risk indicator for pain: odds ratio: 3.48, p=0.005, 95% CI: 1.45-8.38. This finding supports the hypothesis that as a result of CRF, disruptions of cortico-cortico and cortico-subcortical pathways occur, and consequently, enhances pain in this group of patients.
Achterberg
W P
WP
EMGO-Institute and Department of Nursing Home Medicine, VU University Medical Center Amsterdam, The Netherlands. wp.achterberg@vumc.nl
Scherder
E
E
Pot
A M
AM
Ribbe
M W
MW
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015140:Dementia, Vascular / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009426:Netherlands; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D009735:Nursing Homes / Q000706:statistics & numerical data* / Q000639:trends; D010146:Pain / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution