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- Title
Pain management in older adults with dementia: A selective review.
- Authors
Koo, Vanessa; Shicheng Jin; Wan, Bo Angela; Ahrari, Soha; Lam, Henry; Rowbottom, Leigha; Chow, Selina; Chow, Ronald; Chow, Edward; DeAngelis, Carlo
- Abstract
Dementia affects over 47 million people globally, and this number is projected to exceed 100 million by 2050. Dementia in the elderly is characterized by progressive cognitive and functional decline. As there is no cure for dementia, care is focused on pain management as many individuals experience pain from comorbidities. However, clear guidance on evidence-based pain management strategies for dementia patients is lacking. The purpose of the review was to examine pain management strategies in the older adults with dementia because often pain and pain medications can lead to exacerbations in cognitive symptoms. A selective literature search was conducted using Ovid MEDLINE, Embase Classic, Embase and Cochrane Central Register of Controlled Trials. Subject headings/keywords included: "older adults," "dementia," "pain," and "pain management." The search produced 1,033 articles, of which 11 were included in the final review. There is evidence that pharmacological pain management strategies employing acetaminophen as a first line treatment or as part of a stepped care approach i n patients with dementia reduced pain and dementiaassociated behavioural symptoms, and improved activities of daily living. There is mixed or limited literature regarding the use of other pharmacological agents including opioids to manage pain. There is mixed or limited evidence to support non-pharmacological strategies such as the Namaste Care Program, music intervention, ear acupressure, and massage therapy for pain management in this population. Stepped-care approaches with acetaminophen show promise to reduce pain and dementia-associated behavioural symptoms. Other pharmacological/non-pharmacological management strategies require additional research to determine their effectiveness for managing pain.
- Subjects
ACETAMINOPHEN; ANALGESICS; DEMENTIA; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; MEDLINE; NARCOTICS; PAIN management; SYSTEMATIC reviews; ACTIVITIES of daily living; OLD age
- Publication
Journal of Pain Management, 2018, Vol 11, Issue 4, p333
- ISSN
1939-5914
- Publication type
Article