Logo image
Back
Experimentally evoked pain in Alzheimer's disease
Journal article   Peer reviewed

Experimentally evoked pain in Alzheimer's disease

Alison R Anderson, W Larkin Iversen, Michael A Carter, Karen O Moss, Ronald L Cowan and Todd B Monroe
Journal of the American Association of Nurse Practitioners, Vol.34(1), pp.18-25
03/12/2021
DOI: 10.1097/JXX.0000000000000580
PMCID: PMC9118535
PMID: 33731557
url
https://www.ncbi.nlm.nih.gov/pmc/articles/9118535View
Open Access

Abstract

Pain continues to be underrecognized and undertreated in Alzheimer's disease (AD) while existing guidance about pain assessment and management in dementia is not widespread. Brain regions involved in pain processing and modulation are damaged during AD, and the pain experience in AD is not well understood. Experimental pain studies using psychophysics can further our understanding of the pain experience in AD, which may lead to improved assessment and management of pain in people living with AD. A systematic review was conducted to explicate the current understanding of experimentally evoked pain in AD from primary research using psychophysical methods. Peer-reviewed publications were found via PubMed, CINAHL, and PsycINFO. A total of 18 primary research, peer-reviewed full articles that met inclusion criteria were included, representing 929 total participants. Experimentally evoked pain in people with AD demonstrates that despite cognitive impairment and a reduced ability to effectively communicate, individuals with AD experience pain similar to or more unpleasant than cognitively intact older adults. This may mean amplified pain unpleasantness in people with AD. Our current best practices need to be widely disseminated and put into clinical practice. Self-report of pain continues to be the gold standard, but it is ineffective for noncommunicative patients and those unable to understand pain scales or instructions because of memory/cognitive impairment. Instead, pain treatment should be ethically initiated based on patient reports and behaviors, caregiver/surrogate reports, review of the medical record for painful conditions, analgesic trials, and regular reassessments.
 Aged Alzheimer Disease - complications Brain Cognitive Dysfunction - etiology Humans Pain - etiology Pain Measurement

Details

Metrics

9 Record Views
13 Times Cited - Web of Science
Logo image