Long-term care facility residents with dementia and uncontrolled pain are more likely to exhibit adverse behavioral and psychological symptoms, a new study finds.
Considering the risks of psychotropic medication often used to treat these problems, good pain control is paramount, the researchers said.
Associations between pain, depression and behavioral symptoms are well-known among older adults with intact cognition. But this link is less clear among those with cognitive impairment, reported lead author Almut G. Winterstein, Ph.D., of the University of Florida College of Pharmacy.
To shed more light on the subject, Winterstein and her colleagues analyzed Medicare records from long-term care residents aged 50 years or older who had Alzheimer’s or related dementia and chronic pain. Data was drawn from Minimum Data Set 3.0 records between 2011 and 2015.
When compared to their peers whose pain was well-controlled, residents with dementia and uncontrolled pain had a higher risk of developing depression and behavioral symptoms. The latter included signs of psychosis such as delusions or hallucinations, and disruptive behavior such as rejection of care, or physical and verbal aggression.
Notably, uncontrolled pain was more likely to occur among study participants who were younger (ages 50 to 64 years old), female and white, took prescription pain medication, and had five or more comorbidities.
The findings underscore the importance of pain assessment and control in preventing these outcomes, Winterstein and colleagues concluded.
“Overall, our findings may assist healthcare professionals in distinguishing LTC residents with Alzheimer’s and related dementias who have a higher predisposition to depression or behavioral symptoms,” they wrote. “It is particularly important to focus on residents with ADRD who are younger, female, white, and have multiple comorbidities, all of which are important risk factors associated with uncontrolled pain demonstrated in the present study.”
Full findings were published in JAMDA.
