Open Access 01-12-2015 | Erratum
Erratum to: Association between pain, neuropsychiatric symptoms, and physical function in dementia: a systematic review and meta-analysis
Published in: BMC Geriatrics | Issue 1/2015
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The original version of this article unfortunately contained some mistakes. The presentation of Table 2, Table 5 and Table 6 was incorrect. The corrected tables are given below.
Measurement of pain
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Measurement of neuropsychiatric symptoms
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Measurement of function
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||||
---|---|---|---|---|---|---|
First author
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Rating scale
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Method of detection
|
Rating scale
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Method of detection
|
Rating scale
|
Method of detection
|
Ahn 201336
|
MDS pain severity scale, combining pain frequency and pain intensity
|
Self-report, if not possible staff report based on proxy reports
|
MDS subscales; wandering-item, aggression behaviour scale (ABS), challenging behaviour profile (CBP) agitation subscale
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Patient self-report, proxy and professional
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MDS-ADL long form (7 items)
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Staff observation
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Bartels 20038
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No use of rating scale
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Data collection instrument (3-month period), raters unknown
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MDS for depression
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Medical records
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MDS (number of ADLs)
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Medical records
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Black 200639
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No use of rating scale
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Medical records, preceding 6 months, interview surrogate and physician
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No use of rating scales
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Medical records, preceding 6 months, interview proxy and staff
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No use of rating scale
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Medical records, preceding 6 months, interview proxy and staff
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Brummel-Smith 200240
|
1 out of 3 scales: faces or line scale, or word-based pain intensity scale
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self-report, assessed by trained research assistants
|
No use of rating scales
|
Trained research assistants
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No use of rating scale
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Trained research assistants
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Cipher 20044
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GMPI pain and suffering subscale
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Part of neuropsychological evaluation by a licensed clinical geropsychologist
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-GDS-15 “-26 dysfunctional behaviours with scores “1-7”
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Part of neuropsychological evaluation by a licensed clinical geropsychologist
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PRADLI
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Part of neuropsychological evaluation by a licensed clinical geropsychologist
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Cipher 200641
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GMPI
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Part of neuropsychological evaluation by a licensed clinical geropsychologist and each instrument was administered after interviewing the resident, nursing staff and family members
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GLDS, 19 categories with scores 1-7
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Part of neuropsychological evaluation by a licensed clinical geropsychologist and each instrument was administered after interviewing the resident, nursing staff and family members, Medical records, preceding 6 to max 26, Months
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GLDS
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Part of neuropsychological evaluation by a licensed clinical geropsychologist and each instrument was administered after interviewing the resident, nursing staff and family members
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D’Astolfo 200644
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No use of rating scale
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Medical records, preceding 6 to max 26 months
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No use of rating scales
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No use of rating scale
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Medical records Ambulatory status: independent, requires assistance, wheel chair (or bedridden n?=?1)
|
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Gruber-Baldini 200545
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PGC-PIS, score ≥ 2
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Rating by supervisory staff member
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CSDD
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Rating by supervisory staff member
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MDS; activities of daily living scale, SMOI
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Rating/observation by supervisory staff member
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CMAI
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||||||
Kunik 200530
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PGC-PIS, item on level of pain in previous week, scores 1-6
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Interview with patient and proxy by trained interviewer/research assistant
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CMAI
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Interview with patient and proxy by trained interviewer/research assistant
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-
|
-
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HAM-D
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||||||
NPI (subdomains delusion/hallucinations)
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||||||
Leonard 200650
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MDS pain burden using a 4-level composite score based on pain frequency and intensity
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-
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MDS (Physical aggression: MDS item 'others were hit, shoved, scratched, sexually abused'; Depression: MDS score ≥3 on sum of 9 items, e.g. 'being sad', 'making negative statements', 'persistent anger with self or others', 'pained facial expressions'. (At least once in week before)
|
-
|
-
|
-
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Leong 200735
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PAINAD for non-communicative patients
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Interviews with patient and staff member by professionals for communicative patients
|
Depression with GDS-15 or STAI
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Self-report or staff report
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AAS
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Not reported
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Anxiety with Cornell
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||||||
Lin 201146
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PAINAD-Chinese version
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Observation immediately following instances of routine care by principal investigator and research assistant
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No use of rating scales
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Medical records and observations by professional
|
No use of rating scale
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Medical records and observation by professional
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Morgan 201247
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PGC-PIS worst pain item
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Not reported
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CMAI aggression subscale
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Not reported
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-
|
-
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CMAI non-aggressive physical agitation subscale
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||||||
HAM-D depression
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||||||
Norton 201042
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PPQ, intensity item, 10–14 day baseline
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Primary CNA and data used from medical records
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RMBPC-NH, selection of 3 need driven behaviours, BEHAVE-AD
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Primary CNA and unit staff
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PSMS
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Nurses and trained research assistants
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Shega 200548
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VDS, 1 item on presence and severity of pain ‘right now’
|
Interviews with patients and caregivers by trained research assistant
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GDS-15
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Interview patient and proxy
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KATZ
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Interview patient and proxy
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CMAI
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IADL
|
|||||
Shega 201049
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VDS, 5 point, ‘pain past 4 weeks’
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Interviews with patient by trained research assistant
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Mental Health screening questionnaire; 5-item and 6 point scale
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Interview with patient by trained research assistant
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OARS/IADL; 3 point scale
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Interview patient by trained research assistant
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Torvik 201048
|
VRS, 4 point, ‘pain right now’
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Patient self-report
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DQoL, 29-items on 5 domains: self-esteem, aesthetics, positive affect, negative affect, belonging
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Not reported
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Barthel
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Self-report and medical records
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Tosato 20123
|
InterRAI LTCF
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InterRAI LTCF questions and observation of behaviour, any type of pain or discomfort of the body in previous 3 days by trained (research) staff
|
InterRAI LTCF 5 behavioural symptoms, previous 3 days
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Not reported
|
MDS ADL Hierarchy Scale
|
Data recorded by study physicians
|
Volicer 200937
|
MDS-RAI pain frequency (item J2a)
|
Combination of physical examination, patient history, observation, consultation caregiver and medical records by staff
|
MDS Depression Rating Scale
|
Combination of physical examination, patient history, observation, consultation caregiver and medical records by staff
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-
|
-
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MDS item J1e for delusions MDS item J1i for hallucinations
|
||||||
Volicer 201151
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MDS
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Combination of physical examination, patient history, observation, consultation caregiver and medical records by staff
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MDS items I1ee, E1a, E1d, E1f, E1b, E1i, E1l, E1m for depression
|
Combination of physical examination, patient history, observation, consultation caregiver and medical records by staff
|
-
|
-
|
MDS for delusions and hallucinations
|
||||||
MDS items B5b, E1b, E4aa, E4da for agitation
|
||||||
Williams 200543
|
PGC-PIS, score =2, and 0–10 pain numeric rating scale
|
Registered nurses or licensed practical nurses and interview with overseeing supervisor
|
CSDD, score =7
|
Rating by care supervisors, registered nurses and licensed practical nurses
|
MDS-ADL
|
Rating by care supervisors, registered nurses and licensed practical nurses
|
CMAI, any behaviour at least weekly
|
APAS
|
|||||
SMOI
|
||||||
Zieber 200538
|
DS-DAT, and a 7-point pain rating scale
|
Trained facility nurses, palliative care nurse consultants
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PAS
|
Trained facility nurses
|
-
|
-
|
Correlates of pain and specified NPS
|
|||||
---|---|---|---|---|---|
First author
|
N
|
Pain: prevalence
|
Neuropsychiatric symptoms: prevalence
|
Correlates of pain with NPS
|
Quality of study
|
Ahn 201336
|
56577
|
Not reported
|
Wandering 9 %
|
AOR 0.77 (95 % CI: 0.73-0.81) with wandering
|
10
|
Subsample without psychotropic medication
|
|||||
AOR 0.72 (95 % CI: 0.63-0.83) with wandering
|
|||||
(Adjusted for cognition, ADL, sociodemographics)
|
|||||
Kunik 200534
|
99
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Pain mean 2.4 (SD 1.2)
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Delusions/hallucinations mean 0.35 (SD 0.48)
|
r = 0.15 (p > 0.05) with psychosis
|
8.5
|
Leong 200735
|
225
|
Pain 44 %, chronic pain 34 %
|
Anxiety 48 %
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SOR 1.8 (95 % CI: 1.0-3.0) with anxiety
|
8.5
|
Norton 201042
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161
|
Not reported
|
BEHAVE-AD mean 6..4 (SD 29.2)
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r = 0.15 (p = 0.08) for pain intensity and emotional behaviour problems
|
9
|
RMBPC-NH mean 1.45 (SD 0.64)
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r = 0.05 (p = 0.58) for pain intensity and resistiveness to care
|
||||
Torvik 201052
|
106
|
Current pain in total group 55 %, in cognitive impaired group 52 %
|
Negative affect index (DQoL) mean 2.0 (SD 0.75), positive affect/humour index (DQoL) mean 3.4 (SD 0.9)
|
p < 0.01 for current pain and negative affect
|
6.5
|
p = 0.11 for current pain and with positive affect/humour
|
|||||
Tosato 20123
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2822
|
Any pain 19 % (moderate/severe/excruciating pain 13 %)
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Behavioural symptoms 37 % Psychiatric symptoms 21 %
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AOR = 0.74 (95 % CI: 0.55-1.0) with wandering
|
11.5
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AOR = 1.4 (95 % CI: 1.08-1.8) with resistance to care
|
|||||
AOR 1.5 (95 % CI: 1.07-2.03) with delusions
|
|||||
AOR 1.06 (95 % CI: 0.80-1.41) with verbal abuse
|
|||||
AOR 1.08 (95 % CI: 0.75-1.55) with physical abuse
|
|||||
(Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition)
|
|||||
Volicer 200937
|
929
|
Daily pain 29 %, less than daily pain 19 %
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Verbally abusive not easily altered 2 %, physically abusive not easily altered 12 %
|
r = 0.07 (p = 0.03) for pain frequency and verbal abuse
|
11
|
AOR = 0.9 (p = 0.53) with resisting care
|
|||||
AOR = 0.7 (p = 1.2) with verbal abuse
|
|||||
AOR = 0.7 (p = 0.16) with physical abuse
|
|||||
Delusions 8 %
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(Both multivariate models among others controlled for resisting care)
|
||||
Hallucinations 9 %
|
|||||
Zieber 200538
|
58
|
Not reported
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Not reported
|
r = 0.46 (p < 0.01) for DS-DAT scores and resisting care
|
8
|
r = 0.42 (p < 0.01) for DS-DAT scores and aberrant vocalization
|
|||||
Pain rating by palliative care nurse consultants:
|
|||||
r = 0.51 (p < 0.01) with resisting care
|
|||||
r = 0.40 (p < 0.01) with aberrant vocalizations
|
|||||
Pain rating by facility nurse:
|
|||||
r = 0.48 (p < 0.01) with resisting care
|
|||||
r = 0.065 (p < 0.63) with aberrant vocalizations
|
|||||
Correlates of pain and unspecified NPS
|
|||||
First author
|
N
|
Pain: prevalence
|
Neuropsychiatric symptoms: prevalence
|
Correlates of pain with unspecified NPS
|
Quality of study
|
Black 200639
|
123
|
Pain 63 %
|
Psychiatric disorders or behaviour problems 85 %, behaviour problems 67 %
|
SOR 1.9 (95 % CI: 0.7-5.3) with psychiatric/behaviour problems
|
6.5
|
SOR 1.2 (95 % CI: 0.5-2.5) with behaviour problems
|
|||||
Brummel-Smith 200240
|
104 (excluding those unable to self-report pain)
|
Moderate-severe pain 60 %
|
≥1 disruptive behaviours (wandering, verbal disruption, physical aggression, regressive behaviour, hallucinations)
|
SOR 1.8 (95 % CI: 0.8-4.0) with ≥ 1 disruptive behaviour
|
7
|
No-mild pain 40 %
|
|||||
50 subject unable to answer
|
|||||
70 % in dementia sample n = 154
|
|||||
Cipher 20044
|
234
|
Persistent pain 72 %
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Dysfunctional behaviours mean 4.4 (SD 0.76)
|
r = 0.22 (p < 0.05) with dysfunctional behaviours
|
7.5
|
Cipher 200641
|
277
|
Acute pain 29 %
|
-
|
r = 0.18 (p < 0.05) with GLDS mean behavioural intensity
|
7.5
|
Chronic pain 59 %
|
|||||
Norton 201042
|
161
|
Not reported
|
BEHAVE-AD mean 61.4 (SD 29.2)
|
r = 0.18 (p = 0.03) for pain intensity and disruptive behaviour problems
|
9
|
RMBPC-NH mean 1.45 (SD 0.64)
|
r = 0.05 (p = 0.53) for pain intensity and global need driven behaviours
|
||||
Tosato 20123
|
2822
|
Any pain 19 % (moderate/severe/excruciating pain 13 %)
|
Behavioural symptoms 37 %
|
AOR = 1.4 (95 % CI: 1.04-1.8) with socially inappropriate behaviour
|
11.5
|
Psychiatric symptoms 21 %
|
(Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition)
|
||||
Williams 200539
|
331
|
Pain 21 %, in nh 23 %, in rc/al 20 % (self-report for subgroup mmse > 10 was higher: 39 % and 25 %)
|
Behavioural symptoms 58 %
|
OR = 1.1 (95 % CI: 0.49-2.29) and AOR = 1.2 (95 % CI: 0.57-2.36) with behavioural symptoms
|
10
|
(Adjusted for: sex, race, age, cognitive status, number of 10 comorbidities, impairments of 7 activities of daily living)
|
Correlates of pain and ADL or IADL
|
|||||
---|---|---|---|---|---|
First author
|
N
|
Pain: prevalence
|
Physical function: prevalence
|
Correlates of pain with ADL or IADL
|
Quality of study
|
Brummel-Smith 200236
|
104 (excluding those unable to self-report pain)
|
Moderate-severe pain 60 %, no-mild pain 40 % (50 subject unable to answer)
|
≥1 ADL limitations
|
SOR 1.9 (95 % CI: 0.6-6.0) with ≥ 1 ADL limitation
|
7
|
92 % in dementia sample (n = 154)
|
|||||
Cipher 20044
|
234
|
Persistent pain 72 %
|
ADL independency mean 0.09 (SD 0.99)
|
Correlations with GMPI ’pain and suffering’
|
7.5
|
r = −0.04 (α > 0.05) with ADL independency
|
|||||
Shega 200544
|
115
|
Any current pain self-report 32 %, caregiver report 53 %
|
KATZ mean 8.5 (SD 2.7), IADL mean 15.3 (SD 3.9)
|
For self-report pain
|
9.5
|
No association ADL and IADL (p > 0.05)
|
|||||
For caregiver pain report
|
|||||
No association with ADL or IADL (p > 0.05)
|
|||||
Shega 201045
|
5549
|
Moderate or greater pain: 35.8 %
|
Any IADL impairment: 66.5 %
|
OR = 1.74 (95 % CI: 1.15-2.62) with any iADL impairment
|
9
|
(Adjusted for demographics)
|
|||||
Torvik 201048
|
106
|
Current pain in total group 55 %, in cognitive impaired group 52 %
|
Highly or moderate ADL dependent 36 %
|
p = 0.20 for current pain and ADL
|
6.5
|
SOR = 0.5 (95 % CI: 0.2-1.2) for current pain and ADL high/medium v.s. low
|
|||||
Tosato 20123
|
2822
|
Any pain 19 % (moderate/severe/excruciating pain 13 %)
|
No disability 8 %, assistance required 43 %, dependent 49 %
|
SOR 1.0 (95 % CI: 0.9-1.2) with ADL-dependent
|
11.5
|
SOR 0.9 (95 % CI: 0.75-1.09) with ADL assistance required
|
|||||
(Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition)
|
|||||
Correlates of pain and other functional impairments
|
|||||
First author
|
N
|
Pain: prevalence
|
Physical function: prevalence
|
Correlates of pain with ADL or IADL
|
Quality of study
|
Black 200639
|
123
|
Pain 63 %
|
Nutrition/hydration problems total sample 85 %
|
SOR 1.9 (95 % CI: 0.7-5.3) with nutrition/hydration problems
|
6.5
|
Brummel-Smith 200240
|
104 (excluding those unable to self-report pain)
|
Moderate-severe pain 60 %, no-mild pain 40 % (50 subject unable to answer)
|
≥1 ADL limitations
|
SOR 1.6 (95 % CI: 0.6-4.2) with bladder incontinence
|
7
|
92 % in dementia sample (n = 154)
|
|||||
D’Astolfo 200644
|
140
|
Pain 64 % (musculoskeletal pain 40 %)
|
Use of wheel chair 60 %
|
SOR 1.5 (95 % CI: 0.7-3.0) with use of wheel chair or bedridden
|
7
|
Requires assistance 34 %
|
SOR 1.0 (95 % CI: 0.5-2.0) with requires assistance
|
||||
(Analyses in sample of no dementia-severe dementia)
|
|||||
Lin 201146
|
112
|
Observed pain 37 % (PAINAD > =2)
|
Being restrained 46 %; observed care activities: bathing 43 %, assisted transfer 31 %, self-transfer 26 %
|
OR = 5.4 (95 % CI: 2.3-12.5) and AOR = 3.0 (95 % CI: 1.0-8.7) with being restrained
|
12
|
OR = 23.4 (95 % CI: 3.0-188) and AOR = 19.2 (95 % CI: 2.3-162) with bathing
|
|||||
OR = 29.7 (95 % CI: 3.6-242) and AOR = 11.3 (95 % CI: 1.2-102) with assisted transfer, both compared to self-transfer
|
|||||
(Adjusted for gender, age, wound, restraint, tube present in body, recent fall, severity of dementia and type of activity)
|
|||||
Williams 200543
|
331
|
Pain 21 %, in nh 23 %, in rc/al 20 % (self-report for subgroup MMSE > 10 was higher: 39 % and 25 %)
|
Low activity 47 %, immobile 12 %
|
OR = 0.65 (95 % CI: 0.38-1.11) and AOR = 0.64 (95 % CI: 0.37-1.10) with low activity
|
10
|
Low food intake 53 %
|
OR = 1.1 (95 % CI: 0.49-2.29) and AOR = 0.8 (95 % CI: 0.37-1.69) with immobility
|
||||
Low fluid intake 51 %
|
OR = 1.18 (95 % CI: 0.64-2.17) and AOR = 1.03 (95 % CI: 0.56-1.87) with low food intake
|
||||
OR = 1.20 (95 % CI: 0.67-2.15) and AOR 1.14 (95 % CI: 0.66-1.99) with low fluid intake
|
|||||
(Adjusted for: sex, race, age, cognitive status, number of 10 comorbidities, impairments of 7 activities of daily living)
|