The Assessment and Management of Pain in the Demented and Non-Demented Elderly Patient

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Andrade, D.C., Faria, J.W., Caramelli, P., Alvarenga, L., Galhardoni, R., & Siqueira, S.R…Teixeira, M.L. (2010): Pain: elderly patients. Arq Neuropsiquiatr 2011; 69(2-B): 387-394.
The authors reviewed various double blind, randomized, controlled trials along with their systematic reviews to evaluate different methods of assessing and managing pain in demented and non-demented elderly people. They utilized articles published in Scopus, Pubmed and Web of Science from the years 1966 to 2010. In this literature they reviewed the physiology of pain in the elderly and the different available ways of assessment and management of their pain. World’s elderly population is on the rise because of the wider age span. At the same time, chronic degenerative diseases, for example cardiovascular disease, osteoporosis, depression and cancer, prevail in them, thus increasing the chances of chronic pain. Persistent pain has been reported to be in 45-80% of the population. It causes dependency, decrease mobility and higher financial stress. Proper assessment helps in treating pain in the general population. But when we deal with demented people like Alzheimer’s patients, pain goes unreported or under assessed. Alzheimer’s disease (AD) is affecting almost 5% of people, aged 65 years. It makes almost one third of people above the age of 85 years. Several studies in the past have shown that demented patients have high pain prevalence and under-treated pain creates further dependency, cognitive deficiency, insomnia and depression. Physiology of Pain in the Elderly

The authors state that many studies have been conducted to find the clues regarding how differently the elderly folks, specially demented, perceive pain as compared to the younger, non-demented people. These studies were heterogeneous and involved small group of people. Experimental pain, for example by using electrical stimulation and a tourniquet, was inflicted in different body parts...
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