Pain in patients with different dementia subtypes, mild cognitive impairment, and subjective cognitive impairment

Tarik T. Binnekade, Erik J.A. Scherder, Andrea B. Maier, Frank Lobbezoo, Eduard J. Overdorp, Didi Rhebergen, Roberto S.G.M. Perez, Joukje M. Oosterman

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objective: To assess the pain prevalence, pain intensity, and pain medication use in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI).

Design: Cross-sectional.

Setting: Outpatient memory clinics.

Subjects: In total, 759 patients with Alzheimer's disease (AD), vascular dementia, mixed AD and vascular pathology (MD), frontotemporal dementia, dementia with Lewy Bodies, MCI, or SCI.

Methods: Self-reported presence and intensity of pain, prescribed medication, and related descriptive variables were given for each group. To compare groups on prevalence of pain, logistic regression analyses were adjusted for age, gender, and mood. Differences in pain intensity were tested using a Kruskall-Wallis test, and differences in analgesic use with chi-square analyses.

Results: Pain prevalence ranged from 34% in MD to 50% in SCI. AD (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.34-0.93) and MD (OR = 0.45, CI = 0.20-0.98) patients were less likely to report pain than SCI patients. The self-reported pain intensity did not differ between groups. In total, 62.5% of patients did not use any analgesic medication despite being in pain, which did not differ significantly between groups.

Conclusion: Outpatient memory clinic patients with mild to moderate AD and MD are less likely to report pain than patients with SCI. No difference in self-reported pain intensity was present. The high percentage of patients with and without dementia who do not use analgesics when in pain raises the question of whether pain treatment is adequate in older patients.

Original languageEnglish
Pages (from-to)920-927
Number of pages8
JournalPain Medicine
Volume19
Issue number5
Early online date17 Jul 2017
DOIs
Publication statusPublished - 1 May 2018

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Dementia
Pain
Alzheimer Disease
Analgesics
Ambulatory Care Facilities
Cognitive Dysfunction
Odds Ratio
Confidence Intervals
Lewy Body Disease
Frontotemporal Dementia
Vascular Dementia
Blood Vessels
Logistic Models
Regression Analysis
Pathology

Keywords

  • Alzheimer?s Disease
  • Dementia
  • Pain
  • Pain Treatment

Cite this

Binnekade, Tarik T. ; Scherder, Erik J.A. ; Maier, Andrea B. ; Lobbezoo, Frank ; Overdorp, Eduard J. ; Rhebergen, Didi ; Perez, Roberto S.G.M. ; Oosterman, Joukje M. / Pain in patients with different dementia subtypes, mild cognitive impairment, and subjective cognitive impairment. In: Pain Medicine. 2018 ; Vol. 19, No. 5. pp. 920-927.
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abstract = "Objective: To assess the pain prevalence, pain intensity, and pain medication use in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI).Design: Cross-sectional.Setting: Outpatient memory clinics.Subjects: In total, 759 patients with Alzheimer's disease (AD), vascular dementia, mixed AD and vascular pathology (MD), frontotemporal dementia, dementia with Lewy Bodies, MCI, or SCI.Methods: Self-reported presence and intensity of pain, prescribed medication, and related descriptive variables were given for each group. To compare groups on prevalence of pain, logistic regression analyses were adjusted for age, gender, and mood. Differences in pain intensity were tested using a Kruskall-Wallis test, and differences in analgesic use with chi-square analyses.Results: Pain prevalence ranged from 34{\%} in MD to 50{\%} in SCI. AD (odds ratio [OR] = 0.56, 95{\%} confidence interval [CI] = 0.34-0.93) and MD (OR = 0.45, CI = 0.20-0.98) patients were less likely to report pain than SCI patients. The self-reported pain intensity did not differ between groups. In total, 62.5{\%} of patients did not use any analgesic medication despite being in pain, which did not differ significantly between groups.Conclusion: Outpatient memory clinic patients with mild to moderate AD and MD are less likely to report pain than patients with SCI. No difference in self-reported pain intensity was present. The high percentage of patients with and without dementia who do not use analgesics when in pain raises the question of whether pain treatment is adequate in older patients.",
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Binnekade, TT, Scherder, EJA, Maier, AB, Lobbezoo, F, Overdorp, EJ, Rhebergen, D, Perez, RSGM & Oosterman, JM 2018, 'Pain in patients with different dementia subtypes, mild cognitive impairment, and subjective cognitive impairment' Pain Medicine, vol. 19, no. 5, pp. 920-927. https://doi.org/10.1093/pm/pnx162

Pain in patients with different dementia subtypes, mild cognitive impairment, and subjective cognitive impairment. / Binnekade, Tarik T.; Scherder, Erik J.A.; Maier, Andrea B.; Lobbezoo, Frank; Overdorp, Eduard J.; Rhebergen, Didi; Perez, Roberto S.G.M.; Oosterman, Joukje M.

In: Pain Medicine, Vol. 19, No. 5, 01.05.2018, p. 920-927.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Pain in patients with different dementia subtypes, mild cognitive impairment, and subjective cognitive impairment

AU - Binnekade, Tarik T.

AU - Scherder, Erik J.A.

AU - Maier, Andrea B.

AU - Lobbezoo, Frank

AU - Overdorp, Eduard J.

AU - Rhebergen, Didi

AU - Perez, Roberto S.G.M.

AU - Oosterman, Joukje M.

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N2 - Objective: To assess the pain prevalence, pain intensity, and pain medication use in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI).Design: Cross-sectional.Setting: Outpatient memory clinics.Subjects: In total, 759 patients with Alzheimer's disease (AD), vascular dementia, mixed AD and vascular pathology (MD), frontotemporal dementia, dementia with Lewy Bodies, MCI, or SCI.Methods: Self-reported presence and intensity of pain, prescribed medication, and related descriptive variables were given for each group. To compare groups on prevalence of pain, logistic regression analyses were adjusted for age, gender, and mood. Differences in pain intensity were tested using a Kruskall-Wallis test, and differences in analgesic use with chi-square analyses.Results: Pain prevalence ranged from 34% in MD to 50% in SCI. AD (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.34-0.93) and MD (OR = 0.45, CI = 0.20-0.98) patients were less likely to report pain than SCI patients. The self-reported pain intensity did not differ between groups. In total, 62.5% of patients did not use any analgesic medication despite being in pain, which did not differ significantly between groups.Conclusion: Outpatient memory clinic patients with mild to moderate AD and MD are less likely to report pain than patients with SCI. No difference in self-reported pain intensity was present. The high percentage of patients with and without dementia who do not use analgesics when in pain raises the question of whether pain treatment is adequate in older patients.

AB - Objective: To assess the pain prevalence, pain intensity, and pain medication use in older patients with a diagnosed subtype of dementia, mild cognitive impairment (MCI), or subjective cognitive impairment (SCI).Design: Cross-sectional.Setting: Outpatient memory clinics.Subjects: In total, 759 patients with Alzheimer's disease (AD), vascular dementia, mixed AD and vascular pathology (MD), frontotemporal dementia, dementia with Lewy Bodies, MCI, or SCI.Methods: Self-reported presence and intensity of pain, prescribed medication, and related descriptive variables were given for each group. To compare groups on prevalence of pain, logistic regression analyses were adjusted for age, gender, and mood. Differences in pain intensity were tested using a Kruskall-Wallis test, and differences in analgesic use with chi-square analyses.Results: Pain prevalence ranged from 34% in MD to 50% in SCI. AD (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.34-0.93) and MD (OR = 0.45, CI = 0.20-0.98) patients were less likely to report pain than SCI patients. The self-reported pain intensity did not differ between groups. In total, 62.5% of patients did not use any analgesic medication despite being in pain, which did not differ significantly between groups.Conclusion: Outpatient memory clinic patients with mild to moderate AD and MD are less likely to report pain than patients with SCI. No difference in self-reported pain intensity was present. The high percentage of patients with and without dementia who do not use analgesics when in pain raises the question of whether pain treatment is adequate in older patients.

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KW - Dementia

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