[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 2 Issue 1, August 2011].
This research investigated whether the treatment of pain could reduce agitation in people with moderate to severe dementia living in nursing homes. The study involved 352 residents with moderate to severe dementia and clinically significant behavioural disturbances.
Participants in the intervention group received daily treatment of pain for eight weeks, with paracetamol (acetaminophen), morphine, buprenorphine transdermal patch, or pregabaline. The control group received usual treatment and care.
The primary outcome measure was agitation (scored using the Cohen-Mansfield agitation inventory). Secondary outcome measures were aggression (scored using the Neuropsychiatric Inventory – Nursing Home version), pain (scored using Mobilisation-Observation-Behaviour-Intensity-Dementia-2), activities of daily living, and cognition (scored using the Mini-Mental State examination).
Agitation was found to be significantly reduced in the intervention group compared with control group after eight weeks. Treatment of pain was also significantly beneficial for the overall severity of neuropsychiatric symptoms, but the groups did not differ significantly for activities of daily living or cognition.
The authors conclude that the systematic management of pain can significantly reduce agitation in residents of nursing homes with moderate to severe dementia. Effective pain management can be important in the treatment of agitation and could offer a means of reducing the unnecessary prescription of antipsychotic drugs.
Full Text Link (a) (free article, open access)
Husebo, BS. Ballard, C. [and] Sandvik, R. [et al] (2011). Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. BMJ, July 17th 2011; 343: d4065.
Full Text Link (b) Athens password or journal subscription required.
Rosenberg, PB. Lyketsos, CG. [and] Plank Althouse, E. (2011). Treating agitation in dementia: A systematic pain management protocol may help. BMJ, July 17th 2011; 343: d3913.