Uncontrolled Pain and Risk for Depression and Behavioral Symptoms in Residents With Dementia.
Yu-Jung Jenny Wei, Cheng Chen, Roger B Fillingim and 5 others
PMID 34089652WHAT IT FOUND
In nursing home residents with dementia, uncontrolled pain was associated with higher risk of later depression and behavioral symptoms.
Key findings
01In weighted analysis accounting for time-varying pain and confounders, uncontrolled pain was associated with a 67% increased risk of depression and a 28% increased risk of behavioral symptoms.
02The association was stronger among residents with no baseline prescription pain treatment or no pain management than among those who had received such interventions.
03Residents with uncontrolled pain were more likely to be younger, female, White, and have five or more comorbidities.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational study, not a trial, so it cannot show that treating pain causes fewer symptoms. The study relied on MDS 3.0 assessments of pain, depression, and behavior, and their validity in residents with dementia is uncertain. Residents with missing pain data were excluded, and the sample was limited to Medicare-covered older adults in long-term care. Unmeasured confounders could still explain part of the association. The study included only residents with chronic pain and without cancer, palliative, or hospice care, so it says little about other pain populations.
Declared interests
The authors reported no conflicts of interest. The paper is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that treating pain will reduce depression or behavioral symptoms. This was an observational cohort study; it showed an association over time, not the effect of a pain treatment.