Comprehension of pain self assessment scales is related to global intellectual impairment but not to specific cognitive deficits in demented elderly
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| Pautex, Sophie, Geneva University Hospitals, Department of Geriatrics, Geneva, Switzerland, Fabjan, Malika, Geneva University Hospitals, Department of Geriatrics, Geneva, Switzerland, Le Lous, Paulette, Geneva University Hospitals, Department of Geriatrics, Geneva, Switzerland, Herrmann, Franc¸ois R., Geneva University Hospitals, Department of Geriatrics, Geneva, Switzerland, Gold, Gabriel, Geneva University Hospitals, Department of Geriatrics, Geneva, Switzerland |
Objective: Pain is very common in elderly patients with dementia. The aim of this study was to identify which cognitive functions were required to reliably comprehend unidimensional pain scales in demented elderly?
Method: Four unidimensional scales: the verbal, horizontal and vertical visual analog and faces pain scales were administered in randomised order to demented patients. All patients underwent a complete neuropsychological evaluation. We evaluated the association between different subscores (memory, construction, initiation, conceptualisation and attention) of the Mattis Dementia Rating Score (MDRS) and the comprehension of the above four pain scales using the Chi-square test.
Results: 62 patients were included (mean age 83.8 years; 37 Alzheimer, 19 mixed and 4 vascular). 46 patients (group A) understood the four pain scales reliably and 16 patients did not (group B). Mean MMSE was 19.89/3.9 for group A and 16.69/4.08 for group B (p=0.08) Mean MDRS was 1079/10 for group A and 979/13 for group B (p=0.02). None of the MDRS subscores were significantly associated with comprehension of the different pain scales although there was a trend for attention (p-0.07).
Conclusion: In older demented individuals, global MDRS scores are better predictors of the comprehension of unidemensional pain scales than specific cognitive subscores, with the possible exception of attention.
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