Pain May Cause Disruptive Behaviors in Residents With Dementia
Pain prevalence rates in older people with dementia have been reported to range between 28% and 83%, with many patients experiencing persistent pain. This is likely because these persons’ ability to effectively communicate their pain is hampered, particularly as their cognitive function declines, and it has been suggested that they exhibit disruptive behaviors as a result of their pain. To gain insights on this issue, Hyochol Ahn, PhD, and Ann Horgas, PhD, Department of Adult and Elderly Nursing, College of Nursing, University of Florida, conducted a study to assess how pain impacts the behavior patterns of nursing home residents with dementia. The results were recently published in BMC Geriatrics (www.ncbi.nlm.nih.gov/pmc/articles/PMC3573898).
Ahn and Horgas used the Need-Driven Dementia-Compromised Behavior model as a guide to conducting their secondary analysis of Minimum Data Set (MDS) 2.0 assessment data on long-term care from the state of Florida for the 2009 calendar year. Pain was considered a proximal factor while level of cognitive impairment, ability to perform activities of daily living, and demographic characteristics were considered background factors to any disruptive behaviors. The investigators assessed data for residents aged 65 years and older who had received a diagnosis of dementia (N=56,577). The MDS pain severity scale was used to measure both pain frequency and pain intensity. Analysis showed that residents experiencing more severe pain were less likely to wander, but were more likely to display aggression and agitated behaviors.
Based on these results, the authors concluded that the relationship between pain and disruptive behaviors depends on the type of behaviors displayed, as wandering (ie, a locomotive disruptive behavior) was not associated with pain, whereas aggression and agitation (ie, nonlocomotive disruptive behaviors) were both positively correlated with pain. The results also indicate that effective pain management may help to reduce aggression and agitation while promoting mobility in persons with dementia.
