Pain treatment of agitation in patients with dementia: A systematic review

International Journal of Geriatric Psychiatry

Volumn 26, Issue 10, 2011, Pages 1012-1018

  Husebo, B S ^a   Ballard, C ^b   Aarsland, D ^c,d  

^a UNIVERSITY OF BERGEN   (Norway)

^b KING'S COLLEGE LONDON   (United Kingdom)

^c STAVANGER UNIVERSITY HOSPITAL   (Norway)

^d AKERSHUS UNIVERSITY HOSPITAL   (Norway)

Author keywords

aggression; agitation; behavioral disturbances; dementia; pain; pain treatment

Indexed keywords

ANALGESIC AGENT; ANTIDEPRESSANT AGENT; MORPHINE; NEUROLEPTIC AGENT; OPIATE; OXYCODONE; PARACETAMOL;

AGITATION; ANALGESIA; BEHAVIOR DISORDER; DEMENTIA; DRUG DOSE ESCALATION; DRUG EFFICACY; DRUG RESPONSE; DRUG WITHDRAWAL; HUMAN; LOW DRUG DOSE; OBSERVATIONAL STUDY; PAIN; PSYCHOPHARMACOTHERAPY; RANDOMIZED CONTROLLED TRIAL (TOPIC); RETROSPECTIVE STUDY; REVIEW; SYSTEMATIC REVIEW; TRANQUILIZING ACTIVITY;

AGED; AGED, 80 AND OVER; ANALGESICS; DEMENTIA; FEMALE; HUMANS; MALE; PAIN; PSYCHOMOTOR AGITATION; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 79960685633     PISSN: 08856230     EISSN: 10991166     Source Type: Journal    
DOI: 10.1002/gps.2649     Document Type: Review

References (58)

1. Alessi CA,. 1991. Managing the behavioral problems of dementia in the home. Clin Geriatr Med 7: 787-801.
2. Allen RS, Thorn BE, Fisher SE, et al,. 2003. Prescription and dosage of analgesic medication in relation to resident behaviors in the nursing home. J Am Geriatr Soc 51: 534-538. (Pubitemid 36457354)
3. Ballard C, O'Brien J,. 1999. Treating behavioural and psychological signs in Alzheimer's diseaseâThe evidence for current pharmacological treatments is not strong. BMJ 319: 138-139.
4. Ballard C, Howard R,. 2006. Neuroleptic drugs in dementia: benefits and harm. Nat Rev Neurosci 7: 492-500. (Pubitemid 44012289)
5. Ballard C, Day S, Sharp S, Wing G, Sorensen S,. 2008. Neuropsychiatric symptoms in dementia: Importance and treatment considerations. Int Rev Psychiatry 20: 396-404.
6. Ballard C, Hanney ML, Theodoulou M, et al,. 2009a. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol 8: 151-157.
7. Ballard CG, Gauthier S, Cummings JL, et al,. 2009b. Management of agitation and aggression associated with Alzheimer disease. Nat Rev Neurol 5: 245-255.
8. Bartels SJ, Horn SD, Smout RJ, et al,. 2003. Agitation and depression in frail nursing home elderly patients with dementiaâTreatment characteristics and service use. Am J Geriatr Psychiatry 11: 231-238. (Pubitemid 36254197)
9. Black BS, Finucane T, Baker A, et al,. 2006. Health problems and correlates of pain in nursing home residents with advanced dementia. Alzheimer Dis Assoc Dis 20: 283-290. (Pubitemid 44900943)
10. Brummel-Smith K, London MR, Drew N, et al,. 2002. Outcomes of pain in frail older adults with dementia. J Am Geriatr Soc 50: 1847-1851. (Pubitemid 35291729)
11. Chenoweth L, King MT, Jeon YH, et al,. 2009. Caring for aged dementia care resident study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol 8: 317-325.
12. Chibnall JT, Tait RC, Harman B, Luebbert RA,. 2005. Effect of acetaminophen on behavior, well-being, and psychotropic medication use in nursing home residents with moderate-to-severe dementia. J Am Geriatr Soc 53: 1921-1929. (Pubitemid 41826069)
13. Chung JA, Cummings JL,. 2000. Neurobehavioral and neuropsychiatric symptoms in Alzheimer's disease-Characteristics and treatment. Neurol Clin 18: 829-837.
14. Cipher DJ, Clifford RA,. 2004. Dementia, pain, depression, behavioral disturbances, and ADLs: toward a comprehensive conceptualization of quality of life in long-term care. Int J Geriatr Psychiatry 19: 741-748. (Pubitemid 39149250)
15. Cipher DJ, Clifford PA, Roper KD,. 2006. Behavioral manifestations of pain in the demented elderly. J Am Med Dir Assoc 7: 355-365. (Pubitemid 44054905)
16. Cohen-Mansfield J, Werner P,. 1997. Management of verbally disruptive behaviors in nursing home residents. J Gerontol A Biol Sci Med Sci 52: M369-M377. (Pubitemid 28007005)
17. Cohen-Mansfield J, Marx MS, Rosenthal AS,. 1990. Dementia and agitation in nursing home residents: how are they related? Psychol Aging 5: 3-8.
18. Cohen-Mansfield J, Libin A,. 2004. Assessment of agitation in elderly patients with dementia: correlations between informant rating and direct observation. Int J Geriatr Psychiatry 19: 881-891. (Pubitemid 39242895)
19. Cohen-Mansfield J, Mintzer JE,. 2005. Time for change: The role of non pharmacological interventions in treating Behavior problems in nursing home residents with dementia. Alzheimer Dis Assoc Dis 19: 37-40. (Pubitemid 40940997)
20. Cohen-Mansfield J, Libin A, Marx MS,. 2007. Nonpharmacological treatment of agitation: A controlled trial of systematic individualized intervention. J Gerontol A Biol Sci Med Sci 62: 908-916. (Pubitemid 350139005)
21. De Deyn PP, Rabheru K, Rasmussen A, et al,. 1999. A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia. Neurology 53: 946-955. (Pubitemid 29442108)
22. De Vugt ME, Riedijk SR, Aalten P, et al,. 2006. Impact of behavioural problems on spousal caregivers: A comparison between Alzheimer's disease and frontotemporal dementia. Dement Geriatr Cogn Disord 22: 35-41.
23. Douzjian M, Wilson C, Shultz M, Berger J, Tapnio J,. 1998. A program to use pain control medication to reduce psychotropic drug use in residents with difficult behavior. Ann Longterm Care 6: 174-179.
24. Feldt KS, Warne MA, Ryden MB,. 1998. Examining pain in aggressive cognitively impaired older adults. J Gerontol Nurs 24: 14-22.
25. Geda YE, Rummans TA,. 1999. Pain: Cause of agitation in elderly individuals with dementia. Am J Psychiatry 156: 1662-1663. (Pubitemid 29460005)
26. Gobert M, D'hoore W,. 2005. Prevalence of psychotropic drug use in nursing homes for the aged in Quebec and in the French-speaking area of Switzerland. Int J Geriatr Psychiatry 20: 712-721. (Pubitemid 41158715)
27. Herr K,. 2004. Assessment of pain in older adults with severe cognitive impairment. Ann Longterm Care 12: 46-52. (Pubitemid 38745578)
28. Herr K, Bjoro K, Decker S,. 2006a. Tools for assessment of pain in nonverbal older adults with dementia: A state-of-the-science review. J Pain Symptom Manage 31: 170-192. (Pubitemid 43243669)
29. Herr K, Coyne PJ, Key T, et al,. 2006b. Pain assessment in the nonverbal patient: Position statement with clinical practice. Pain Manag Nurs 7: 44-52. (Pubitemid 43758001)
30. Husebo BS, Strand LI, Moe-Nilssen R, et al,. 2008. Who suffers most? Dementia and pain in nursing home patients: A cross-sectional study. J Am Med Dir Assoc 9: 427-433.
31. Husebo BS, Strand LI, Moe-Nilssen R, Husebo SB, Ljunggren AE,. 2010. Pain in older persons with severe dementia. Psychometric properties of the mobilization-observation-behaviour-intensity-dementia (MOBID-2) pain scale in a clinical setting. Scand J Caring Sci 2: 380-391.
32. Kovach CR, Noonan PE, Griffie J, Muchka S, Weissman DE,. 2001. Use of the assessment of discomfort in dementia protocol. Appl Nurs Res 14: 193-200. (Pubitemid 33601945)
33. Kovach CR, Noonan PE, Schlidt AM, Wells T,. 2005. A model of consequences of need-driven, dementia-compromised behavior. J Nurs Sch 37: 134-140. (Pubitemid 41638483)
34. Kovach CR, Logan BR, Noonan PE, et al,. 2006. Effects of the serial trial intervention on discomfort and behavior of nursing home residents with dementia. Am J Alzheimers Dis Other Demen 21: 147-155. (Pubitemid 44051051)
35. Lovheim H, Sandman PO, Kallin K, Karlsson S, Gustafson Y,. 2006. Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. Int Psychogeriatr 18: 713-726. (Pubitemid 44623003)
36. Lyketsos CG,. 2007. Neuropsychiatric symptoms (behavioral and psychological symptoms of dementia) and the development of dementia treatments. Int Psychgeriatry 19: 409-420. (Pubitemid 46707421)
37. Mahoney AEJ, Peters L,. 2008. The mahoney pain scale: examining pain and agitation in advanced dementia. Am J Alzheimers Dis Other Demen 23: 250-261. (Pubitemid 351852611)
38. Manfredi PL, Breuer B, Wallenstein S, et al,. 2003. Opioid treatment for agitation in patients with advanced dementia. Int J Geriatr Psychiatry 18: 700-705. (Pubitemid 37009751)
39. Moretti R, Torre P, Antonello RM, Cazzato G,. 2006. Behavioral alterations and vascular dementia. Neurologist 12: 43-47.
40. Morrison RS, Siu AL,. 2000. A comparison of pain and its treatment in advanced dementia and cognitively intact patients with hip fracture. J Pain Symptom Manage 19: 240-248. (Pubitemid 30224690)
41. Petrovic M, Hurt C, Collins D, et al,. 2007. Clustering of behavioural and psychological symptoms in dementia (BPSD): a European Alzheimer's disease consortium (EADC) study. Acta Clin Belg 62: 426-432. (Pubitemid 351236176)
42. Pickering G, Jourdan D, Dubray C,. 2006. Acute versus chronic pain treatment in Alzheimer's disease. Eur J Pain 10: 379-384.
43. Rabins PV,. 1998. The caregiver's role in Alzheimer's disease. Dement Geriatr Cogn Disord 9: 25-28.
44. Rinaldi P, Spazzafumo L, Mastriforti R, et al,. 2005. Predictors of high level of burden and distress in caregivers of demented patients: results of an Italian multicenter study. Int J Geriatr Psychiatry 20: 168-174. (Pubitemid 40277896)
45. Rymer S, Salloway S, Norton L, et al,. 2002. Impaired awareness, behavior disturbance, and caregiver burden in Alzheimer disease. Alzheimer Dis Assoc Disord 16: 248-253. (Pubitemid 35434801)
46. Scherder EJA, Sergeant JA, Swaab DF,. 2003. Pain processing in dementia and its relation to neuropathology. Lancet Neurol 2: 677-686. (Pubitemid 37311321)
47. Schneider LS, Dagerman K, Insel PS,. 2006a. Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. Am J Geriatr Psychiatry 14: 191-210.
48. Schneider LS, Tariot PN, Dagerman KS, et al,. 2006b. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease. N Engl J Med 355: 1525-1538. (Pubitemid 44547805)
49. Schneider LS, Sano M,. 2009. Current Alzheimer's disease clinical trials: methods and placebo outcomes. Alzheimers Dement 5: 388-397.
50. Selbaek G, Kirkevold O, Engedal K,. 2007. The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes. Int J Geriatr Psychiatry 22: 843-849. (Pubitemid 47455265)
51. Shelley BP, Al Khabouri J,. 2007. The spectrum of dementia: Frequency, causes and clinical profile. Dement Geriatr Cogn Disord 24: 280-287.
52. Snow AL, Chandler JF, Kunik ME, et al,. 2009. Self-reported pain in persons with dementia predicts subsequent decreased psychosocial functioning. Am J Geriatr Psychiatry 17: 873-880.
53. Sourial R, McCusker J, Cole M, Abrahamowicz M,. 2001. Agitation in demented patients in an acute care hospital: prevalence, disruptiveness, and staff burden. Int Psychogeriatr 13: 183-197.
54. Steinberg M, Shao H, Zandi P, et al,. 2008. Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the Cache County study. Int J Geriatr Psychiatry 23: 170-177. (Pubitemid 351308497)
55. Testad I, Aasland AM, Aarsland D,. 2005. The effect of staff training on the use of restraint in dementia: a single-blind randomised controlled trial. Int J Geriatr Psychiatry 20: 587-590. (Pubitemid 40873352)
56. Testad I, Aasland AM, Aarsland D,. 2007. Prevalence and correlates of disruptive behavior in patients in Norwegian nursing homes. Int J Geriatr Psychiatry 22: 916-921. (Pubitemid 47455276)
57. Wooltorton E,. 2002. Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials. Can Med Assoc J 167: 1269-1270. (Pubitemid 35370646)
58. Wooltorton E,. 2004. Olanzapine (Zyprexa): increased incidence of cerebrovascular events in dementia trials. Can Med Assoc J 170: 1395. (Pubitemid 38594631)