The assessment and management of pain in the demented and non-demented elderly patient
Persistent pain is a frequent health problem in the elderly. Its prevalence ranges from 45% to 80%. Chronic diseases, such as depression, cardiovascular disease, cancer and osteoporosis have a higher prevalence in aged individuals and increase the risk of developing chronic pain. The presence of pai...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Academia Brasileira de Neurologia (ABNEURO)
2011-01-01
|
| Series: | Arquivos de Neuro-Psiquiatria |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2011000300023&lng=en&tlng=en |
| _version_ | 1818539373167116288 |
|---|---|
| author | D C Andrade J W V Faria P Caramelli L Alvarenga R Galhardoni S R D Siqueira L T Yeng M J Teixeira |
| author_facet | D C Andrade J W V Faria P Caramelli L Alvarenga R Galhardoni S R D Siqueira L T Yeng M J Teixeira |
| author_sort | D C Andrade |
| collection | DOAJ |
| description | Persistent pain is a frequent health problem in the elderly. Its prevalence ranges from 45% to 80%. Chronic diseases, such as depression, cardiovascular disease, cancer and osteoporosis have a higher prevalence in aged individuals and increase the risk of developing chronic pain. The presence of pain is known to be associated with sleep disorders in these patients, as well as functional impairment, decreased sociability and greater use of the health system, with consequent increase in costs. Alzheimer's disease patients seem to have a normal pain discriminative capacity and they may probably have weaker emotional and affective experience of pain when compared to other types of dementia. Many patients have language deficits and thus cannot properly describe its characteristics. In more advanced cases, it becomes even difficult to determine whether pain is present or not. Therefore, the evaluation of these patients should be performed in a systematic way. There are three ways to measure the presence of pain: by direct questioning (self-report), by direct behavioral observation and by interviews with caregivers or informants. In recent years, many pain scales and questionnaires have been published and validated specifically for the elderly population. Some are specific to patients with cognitive decline, allowing pain evaluation to be conducted in a structured and reproducible way. The next step is to determine the type of painful syndrome and discuss the bases of the pharmacological management, the use of multiple medications and the presence of comorbidities demand the use of smaller doses and impose contra-indications against some drug classes. A multiprofessional approach is the rule in the management of these patients. |
| first_indexed | 2024-12-11T21:41:11Z |
| format | Article |
| id | doaj.art-913abf323be14c0cb162c264ae0fba30 |
| institution | Directory Open Access Journal |
| issn | 1678-4227 |
| language | English |
| last_indexed | 2024-12-11T21:41:11Z |
| publishDate | 2011-01-01 |
| publisher | Academia Brasileira de Neurologia (ABNEURO) |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj.art-913abf323be14c0cb162c264ae0fba302022-12-22T00:49:50ZengAcademia Brasileira de Neurologia (ABNEURO)Arquivos de Neuro-Psiquiatria1678-42272011-01-01692b38739410.1590/S0004-282X2011000300023S0004-282X2011000300023The assessment and management of pain in the demented and non-demented elderly patientD C Andrade0J W V Faria1P Caramelli2L Alvarenga3R Galhardoni4S R D Siqueira5L T Yeng6M J Teixeira7Universidade de São PauloUniversidade Federal de UberlândiaUniversidade Federal de Minas GeraisUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloPersistent pain is a frequent health problem in the elderly. Its prevalence ranges from 45% to 80%. Chronic diseases, such as depression, cardiovascular disease, cancer and osteoporosis have a higher prevalence in aged individuals and increase the risk of developing chronic pain. The presence of pain is known to be associated with sleep disorders in these patients, as well as functional impairment, decreased sociability and greater use of the health system, with consequent increase in costs. Alzheimer's disease patients seem to have a normal pain discriminative capacity and they may probably have weaker emotional and affective experience of pain when compared to other types of dementia. Many patients have language deficits and thus cannot properly describe its characteristics. In more advanced cases, it becomes even difficult to determine whether pain is present or not. Therefore, the evaluation of these patients should be performed in a systematic way. There are three ways to measure the presence of pain: by direct questioning (self-report), by direct behavioral observation and by interviews with caregivers or informants. In recent years, many pain scales and questionnaires have been published and validated specifically for the elderly population. Some are specific to patients with cognitive decline, allowing pain evaluation to be conducted in a structured and reproducible way. The next step is to determine the type of painful syndrome and discuss the bases of the pharmacological management, the use of multiple medications and the presence of comorbidities demand the use of smaller doses and impose contra-indications against some drug classes. A multiprofessional approach is the rule in the management of these patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2011000300023&lng=en&tlng=enidosodoença de Alzheimercomprometimento cognitivodor crônicaavaliação da dor |
| spellingShingle | D C Andrade J W V Faria P Caramelli L Alvarenga R Galhardoni S R D Siqueira L T Yeng M J Teixeira The assessment and management of pain in the demented and non-demented elderly patient Arquivos de Neuro-Psiquiatria idoso doença de Alzheimer comprometimento cognitivo dor crônica avaliação da dor |
| title | The assessment and management of pain in the demented and non-demented elderly patient |
| title_full | The assessment and management of pain in the demented and non-demented elderly patient |
| title_fullStr | The assessment and management of pain in the demented and non-demented elderly patient |
| title_full_unstemmed | The assessment and management of pain in the demented and non-demented elderly patient |
| title_short | The assessment and management of pain in the demented and non-demented elderly patient |
| title_sort | assessment and management of pain in the demented and non demented elderly patient |
| topic | idoso doença de Alzheimer comprometimento cognitivo dor crônica avaliação da dor |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2011000300023&lng=en&tlng=en |
| work_keys_str_mv | AT dcandrade theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT jwvfaria theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT pcaramelli theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT lalvarenga theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT rgalhardoni theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT srdsiqueira theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT ltyeng theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT mjteixeira theassessmentandmanagementofpaininthedementedandnondementedelderlypatient AT dcandrade assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT jwvfaria assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT pcaramelli assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT lalvarenga assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT rgalhardoni assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT srdsiqueira assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT ltyeng assessmentandmanagementofpaininthedementedandnondementedelderlypatient AT mjteixeira assessmentandmanagementofpaininthedementedandnondementedelderlypatient |