title: Pain and dementia: a diagnostic challenge.
abstract: OBJECTIVE
  The aim was to present current knowledge about pain assessment in people with dementia and to discuss special challenges and possible solutions.
  
  
  METHODS
  A literature search in MEDLINE® was performed.
  
  
  RESULTS
  Due to the changing demographics of an aging population, an increasing number of people with dementia is expected. Many of these people will simultaneously suffer pain. Under-detection and under-treatment of pain in persons suffering from dementia is often described. As dementia progresses, the ability of the sufferer to verbally communicate his/her pain is often compromised, complicating the task of recognizing and treating pain. To improve pain recognition in dementia, many pain assessment tools have been developed. However, psychometric properties have to date been insufficiently examined.
  
  
  CONCLUSIONS
  Self-report ratings should be performed as long as justifiable. Behavioural pain assessment tools should be used in advanced dementia despite their current imperfections: in particular, the PAINAD for daily use and the PACSLAC at longer intervals. All available additional information about pain should be considered.
authors.affiliation: Stipendiat Forschungskolleg Geriatrie, Robert Bosch Stiftung, AGAPLESION Bethesda Klinik Ulm, Akademisches Krankenhaus der Universität Ulm, Ulm, Deutschland. albert.lukas@bethesda-ulm.de
authors.forename: A
authors.initials: A
authors.lastname: Lukas
authors.forename: M
authors.initials: M
authors.lastname: Schuler
authors.forename: T W
authors.initials: TW
authors.lastname: Fischer
authors.forename: S J
authors.initials: SJ
authors.lastname: Gibson
authors.forename: S M
authors.initials: SM
authors.lastname: Savvas
authors.forename: T
authors.initials: T
authors.lastname: Nikolaus
authors.forename: M
authors.initials: M
authors.lastname: Denkinger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D059026:Diagnostic Self Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity