title: Pain in dementia: prevalence and associated factors: protocol of a multidisciplinary study.
abstract: BACKGROUND
  Pain is a common problem in people with dementia, however the exact prevalence of pain in dementia subtypes, e.g. Alzheimer's Disease (AD), Vascular Dementia (VaD), Frontotemporal Dementia (FTD) and dementia with Lewy Bodies (DLB), is unknown, as is the relation between pain and the different subtypes of dementia. In this study, the prevalence of pain in people with dementia will be investigated per dementia subtype and the relationship between the various subtypes of dementia and the presence of specific types of pain (i.e. musculoskeletal pain, neuropathic pain and orofacial pain) will be examined. Secondly, associations between various types of pain, cognitive functioning, neuropsychiatric symptoms and quality of life in people with dementia will be examined. A third purpose is to study the value of the assessment of autonomic responses in assessing pain in people with dementia. Finally, the effect of feedback to the attending physician on the presence of pain, based on examination by investigators with backgrounds in neuropsychology, geriatric dentistry and elderly care medicine, will be evaluated.
  
  
  METHODS
  A cross-sectional, partially longitudinal observational study in 400 participants with dementia, aged 60 years and older. Participants will be recruited from an outpatient memory clinic and dementia special care units. All participants will be examined by an elderly care medicine trainee, a dentist with experience in geriatric dentistry, and a neuropsychologist. The primary outcome is presence of pain. Secondary outcomes will include oral health, autonomic responses to pain stimulus, vital sensibility and gnostic sensibility, musculoskeletal examination, cognitive functioning, neuropsychiatric symptoms, and quality of life.
  
  
  CONCLUSIONS
  This study will help to enhance our knowledge regarding the prevalence of different types of pain in different dementia subtypes i.e. AD, VaD, FTD and DLB. This study also aims to contribute to a better understanding of oral health status in people with dementia, the use of autonomic responses in the assessment of pain in people with dementia and the relationships between pain and cognitive symptoms, neuropsychiatric symptoms and quality of life in people with various dementia subtypes and in different stages of the disease.
authors: Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. j.vankooten2@vumc.nl.
authors: Janine
authors: J
authors: van Kooten
authors: Department of Clinical Neuropsychology VU University, Amsterdam, The Netherlands. s.delwel@vu.nl.|Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands. s.delwel@vu.nl.
authors: Suzanne
authors: S
authors: Delwel
authors: Department of Clinical Neuropsychology VU University, Amsterdam, The Netherlands. t.t.binnekade@vu.nl.
authors: Tarik T
authors: TT
authors: Binnekade
authors: Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. m.smalbrugge@vumc.nl.
authors: Martin
authors: M
authors: Smalbrugge
authors: Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. j.vanderwouden@vumc.nl.
authors: Johannes C
authors: JC
authors: van der Wouden
authors: Department of Anesthesiology, VU University Medical Center, Amsterdam, The Netherlands. rsgm.perez@vumc.nl.
authors: Roberto S G M
authors: RS
authors: Perez
authors: GGZ InGeest /Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. d.rhebergen@ggzingeest.nl.
authors: Didi
authors: D
authors: Rhebergen
authors: Department of Anesthesiology, VU University Medical Center, Amsterdam, The Netherlands. wwa.zuurmond@vumc.nl.
authors: Wouter W A
authors: WW
authors: Zuurmond
authors: GGZ InGeest /Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. M.Stek@ggzingeest.nl.
authors: Max L
authors: ML
authors: Stek
authors: Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands. f.lobbezoo@acta.nl.
authors: Frank
authors: F
authors: Lobbezoo
authors: Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. cmpm.hertogh@vumc.nl.
authors: Cees M P M
authors: CM
authors: Hertogh
authors: Department of Clinical Neuropsychology VU University, Amsterdam, The Netherlands. eja.scherder@vu.nl.
authors: Erik J A
authors: EJ
authors: Scherder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D018579:Patient Selection; D015995:Prevalence; D011788:Quality of Life