Experimentally evoked pain in Alzheimer's disease.
Alison R Anderson, W Larkin Iversen, Michael A Carter and 3 others
PMID 33731557WHAT IT FOUND
People with Alzheimer's disease did not experience less pain.
They often needed stronger experimental stimuli to detect or report pain, but pain unpleasantness was greater or the same as in healthy older adults.
Key findings
01In stimulus detection outcomes, 5 of 11 showed participants with AD needed higher stimulus intensities, while 6 showed no difference.
02Pain unpleasantness was more unpleasant for participants with AD in 7 of 19 outcomes, the same in 11 outcomes, and less unpleasant in 1 outcome.
03Participants with dementia could not reliably self-report pain, and reliable self-report decreased as cognitive impairment increased.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included only experimental pain studies using psychophysics, so it did not cover observational studies or neuroimaging findings. Some included studies had AD-related dementia other than AD, and older studies may not have specified the dementia type. People with severe AD were underrepresented, and severe AD may respond to pain differently than mild or moderate AD. The review had little research in African American, Hispanic or Asian participants, so ethnic and cultural differences in pain may not be represented. Other factors that affect pain, such as biology, culture and context, were not covered. The neural mechanisms of pain in AD were not investigated in this review.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that people with AD have less pain because they may need a stronger stimulus to detect or report it. The review found pain unpleasantness was greater or the same compared with healthy older adults, and reliable self-report decreased as cognitive impairment increased.