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Are Chronic Pain Patients with Dementia Being Undermedicated?

Authors Achterberg WP, Erdal A, Husebo BS, Kunz M, Lautenbacher S

Received 23 November 2020

Accepted for publication 25 January 2021

Published 15 February 2021 Volume 2021:14 Pages 431—439

DOI https://doi.org/10.2147/JPR.S239321

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Robert B. Raffa


Wilco P Achterberg,1 Ane Erdal,2 Bettina S Husebo,2 Miriam Kunz,3 Stefan Lautenbacher4

1Department of Public Health and Primary Care, Leiden University Medical Center, RC Leiden, 2300, the Netherlands; 2Department of Global Public Health and Primary Care, University of Bergen, Bergen, 5020, Norway; 3Department of Medical Psychology, University of Augsburg, Augsburg, 86156, Germany; 4Department of Physical Psychology, University of Bamberg, Bamberg, Germany

Correspondence: Wilco P Achterberg
Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, Room V6-76, PO Box 9600, RC Leiden, 2300, the Netherlands
Tel +31 71 5268412/8427; + 31 6 23668980
Email w.p.achterberg@lumc.nl

Abstract: In dementia, neuropathological changes alter the perception and expression of pain. For clinicians and family members, this knowledge gap leads to difficulties in recognizing and assessing chronic pain, which may consequently result in persons with dementia receiving lower levels of pain medication compared to those without cognitive impairment. Although this situation seems to have improved in recent years, considerable geographical variation persists. Over the last decade, opioid use has received global attention as a result of overuse and the risk of addiction, while the literature on older persons with dementia actually suggests undertreatment. This review stresses the importance of reliable assessment and the regular evaluation and monitoring of symptoms in persons with dementia. Based on current evidence, we concluded that chronic pain is still undertreated in dementia.

Keywords: pain, dementia, assessment, analgesic treatment

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