Physical inactivity in aging and dementia: a review of its relationship to pain

Aims. The goal of this brief review is to address studies examining the relationship between physical inactivity and pain in aging and dementia. Background. A decrease in the level of physical activity is characteristic of older persons, both with and without dementia. Passive behaviour is often considered to be part of the apathy frequently observed in patients with dementia, although it could also be a sign of pain. Design. Literature review. Method. Searches were performed in PubMed and Embase. A total of 15 studies concerning the relationship between physical inactivity and pain in older persons with and without dementia were identified (older persons without dementia: 12; with dementia: 3). Results. In older persons without dementia, a positive relationship between physical inactivity and pain has been demonstrated. In older persons with dementia, pain may cause physical inactivity and physical inactivity may cause pain. Conclusions. In older persons, a positive relationship between physical inactivity and pain was demonstrated. More specifically, pain may cause physical inactivity. In older persons with dementia pain may cause physical inactivity and vice versa. Relevance to clinical practice. Nurses' awareness of physical inactivity as an indication of pain in older persons with and without dementia may reduce the risk of underdiagnosis and subsequent undertreatment of pain. © 2012 Blackwell Publishing Ltd.