[Dementia and pain].
Dementia has been associated with disturbed pain processing and an impaired ability to provide self-reported ratings on pain. Patients with cognitive impairment have been shown to receive pain treatment less frequently than cognitively unimpaired individuals. Comorbidity is common in patients with dementia and a major factor contributing to pain. This demonstrates that a structured evaluation and categorisation of pain is mandatory for the treatment of older patients and that care should be taken to note indirect signs of pain. The appropriate scales are available and we propagate their application. Multimodal pain therapy is superior to one-dimensional approaches. A discussion of the effects and interactions of the analgesics presently available for geriatric care forms an integral part of this review.
Universitätsklinik für Neurologie, Medizinische Universität Graz. reinhold.schmidt@medunigraz.at
Reinhold
R
Schmidt
Michael
M
Bach
Peter
P
Dal-Bianco
Peter
P
Holzer
Aga
A
Pluta-Fuerst
Eva
E
Assem-Hilger
Anita
A
Lechner
Margherita
M
Cavalieri
Bernhard
B
Haider
Helena
H
Schmidt
Georg
G
Pinter
Wolfgang
W
Pipam
Elisabeth
E
Stögmann
Christian
C
Lampl
Rudolf
R
Likar
D000344:Afferent Pathways / Q000503:physiopathology; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D003131:Combined Modality Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D015140:Dementia, Vascular / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D057180:Frontotemporal Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D009619:Nociceptors / Q000502:physiology; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000187:drug effects / Q000502:physiology; D013116:Spinal Cord / Q000503:physiopathology
D000700:Analgesics; D000701:Analgesics, Opioid