Pain assessment in patients with dementia. Exploratory study in elderly people with Alzheimer's disease and vascular dementia

*Paula Madureira¹, Bruno Peixoto²

Summary
Background. The assessment of pain in dementia patients is a controversial issue and we have witnessed an increasing number of studies in this field. Some advocate the impossibility of using direct pain measures in this population, while others support the view that elderly people with dementia are able to report their pain in a trustworthy manner.
Objective. This work aims to test the possibility of using direct measures of pain in patients with dementia and, at the same time, to characterize the experience of pain in these individuals and to correlate these measures with observational ones. Method.Self-report and behavioural pain measures were applied to three groups: an Alzheimer's Disease (AD) group (n=15); a Vascular Dementia (VD) group, (n=20); and a Control group (n=22).
Results. The obtained results suggest hypointensity in the pain experience in AD patients both in direct and observational measures. This group obtained lower scores on both direct and observational pain measures.
Conclusions. This study suggests that the use of pain self-report measures in early stages of dementia is perfectly plausible. The finding that the experimental groups did not differ from the control group in regard to comprehension of the scales, and the high positive correlation between this type of measure and the observations, support this idea.

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