Interventions targeting pain or behaviour in dementia: a systematic review

Ageing Res Rev. 2013 Sep;12(4):1042-55. doi: 10.1016/j.arr.2013.05.002. Epub 2013 May 28.

Abstract

Background: Both pain and challenging behaviour are highly prevalent in dementia, and multiple studies show that some of these behaviours may be correlated. Pain, especially in non-communicative patients, can cause challenging behaviour, and treatment of pain therefore may have an effect on behaviour. This review aims to provide a comprehensive overview of the current state of evidence regarding the effectiveness of interventions targeting pain on the outcome behaviour, and interventions targeting behaviour on pain, in dementia.

Method: PubMed (MEDLINE), EMBASE, COCHRANE, CINAHL, PsychINFO and Web of Science were searched systematically. Studies were included if they focused on an intervention targeting a reduction in the person's distress, pain, and/or behaviour, and included adults with a main diagnosis of dementia.

Results: Of a total of 893 potentially relevant publications that were identified, 16 publications met the inclusion criteria and were eligible for further analysis; 6 studies focused on a pain intervention targeting behaviour, 1 study focused on a behavioural intervention targeting pain, and 9 studies focused on an intervention targeting both pain and behaviour.

Conclusion: Available evidence suggests that (pain) interventions targeting behaviour, and (behavioural) interventions targeting pain are effective in reducing pain and behavioural symptoms in dementia.

Keywords: Behavior; Dementia; Neuropsychiatric symptoms; Non-pharmacological and pharmacological interventions; Pain.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Analgesics / administration & dosage
  • Animals
  • Catastrophization / diagnosis
  • Catastrophization / psychology
  • Catastrophization / therapy
  • Dementia / diagnosis
  • Dementia / psychology*
  • Dementia / therapy*
  • Drug Delivery Systems / methods
  • Humans
  • Pain / diagnosis
  • Pain / psychology*
  • Pain Management / methods*
  • Pain Management / psychology*
  • Pain Measurement / methods
  • Pain Measurement / psychology
  • Randomized Controlled Trials as Topic / methods

Substances

  • Analgesics