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Table 1 Characteristics of the included studies

From: Association between pain, neuropsychiatric symptoms, and physical function in dementia: a systematic review and meta-analysis

First author Country, setting Dementia Population: selection on pain, NPS or function? Quality of study**
Ahn 2013 [ 36 ] USA, nh Moderate dementia, mean MDS cognitive performance scale 3.17 (SD 1.52) Age ≥ 65 years, excluded when comatose 10
Bartels 2003 [ 8 ] USA, ltc Dementia, AD or signs of chronic stable cognitive impairment (in chart or MDS) At risk for (or having) pressure ulcers 4
Black 2006 [39] USA, nh Advanced dementia, SIRS mean 10.3 (SD 6.7), AD 58% Palliative care (life expectancy ≤6 months) 6.5
Brummel-Smith 2002 [ 40 ] USA, nh Moderate to severe dementia, MMSE mean 16.8 (SD 5.6) for 92 subjects Age ≥ 55 years, had to have pain assessment, able to self-report on their level of pain 7
Cipher 2004 [ 4 ] USA, ltc Moderate dementia, mean NCSE 0.10 (SD 0.91) Referral to clinical psychologist due to change in cognitive functioning, emotional distress, or behavioural dysfunction associated with dementia 7.5
Cipher 2006 [ 41 ] USA, ltc Dementia, mild 40%, moderate 41% and severe 19%, according to FAST (Reisberg) NCSE Referral to clinical psychologist due to change in cognitive functioning, emotional distress, or behavioural dysfunction associated with dementia 7.5
D’Astolfo 2006 [ 44 ] Canada, ltc In 4% no dementia with MMSE>25, mild dementia 27%, moderate 44%, severe 25% Admission in ltc at least 6 months to allow for patient charts to be completed 7
Gruber-Baldini 2005 [ 45 ] USA, nh and residential care/assisted living Dementia, mild 14%, moderate 26% and severe 61%, according to MMSE or MDS-COGS. Random sample aged ≥ 65 years (complete response 60%) 8.5
Kunik 2005 [ 34 ] USA, va outpatients Dementia, mild 46%, moderate 39%, severe 11%, according to DRS. Veteran outpatients, not in LTC-facilities, with available caregiver 8.5
Leonard 2006 [ 50 ] USA, nh Dementia according to CPS-MDS dataset At least one comprehensive MDS assessment, age ≥ 60 years 9
Leong 2007 [ 35 ] Singapore, nh Dementia with 33% mild (MIC) and 41% severe (SIC) cognitive impairment, according to AMT No recent change in cognitive status, age ≥ 65 years. Here report of communicative subgroup with dementia (thus excluding 53 and including 125 of 358). 8.5
Lin 2011 [ 46 ] Taiwan, nh Dementia, 39% profound or end-stage dementia, according to CDR-C. Admission at least 1 month 12
Morgan 2012 [ 47 ] USA, Veterans Administration Medical Centre, longitudinal study Dementia, DemRS2 mean 4.12 (SD 2.79) > 60 years, no aggressive behaviour in past year, no residence in nh and caregiver > 8 hrs a week, no onset of aggression before first follow-up (at 5 mo) 9.5
Norton 2010 [ 42 ] USA, nh Dementia, MMSE mean 6.4 (SD 6.7) Verbal disruption (BEHAVE-AD >= 1.5), age ≥ 55 years, passed audiological assessment, and life expectancy >6 mo 9
Shega 2005 [ 48 ] USA, outpatient geriatrics clinic Dementia, MMSE mean 16.6 (SD 7.2) Patient-caregiver dyad with pain-report on same day (77% of original sample) 9.5
Shega 2010 [ 49 ] Canada, community dwelling Cognitive impairment, 3 MS, mild to moderate dementia 18.5% Community dwelling people aged ≥ 65 years, within one inclusion wave a pain self-assessment was incorporated 9
Torvik 2010 [ 52 ] Norway, nh No (13%), mild (46%) or moderate (41%) cognitive impairment, according to MMSE. MMSE > 11, aged ≥ 65 years (inclusion and response 35% of total sample). Communicative patients 6.5
Tosato 2012 [ 3 ] EU and Israel, nh Cognitive impairment, mild-moderate 55% and severe 45%, according to CPS Several countries 11.5
Volicer 2009 [ 37 ] Netherlands, nh/residential home Dementia, according to MDS-CPS Dependent in decision making, aged ≥ 65 years 11
Volicer 2011 [ 51 ] Netherlands, nh, longitudinal study Dementia, according to MDS Availability of 4 quarterly MDS assessments within period of 15 months, aged ≥ 65 years 12
Williams 2005 [ 43 ] USA, nh and residential care/assisted living Dementia, with 29% MMSE>10 and MDS-COGS >2-4 Available pain data, aged ≥ 65 years 10
Zieber 2005 [38] Canada, ltc Moderate to severe cognitive impairment, according to FAST (Reisberg) score 6-7 Residents with continuous nursing care because of significant physical and/or cognitive impairments (‘nh-level’) 8
  1. Abbreviations: nh, nursing home; MDS, Minimum Dataset; ltc, long term care facility; AD, Alzheimer’s Disease; SIRS, The Severe Impairment Rating Scale; MMSE, Mini Mental State Examination; NCSE, Neurobehavioural Cognitive Status Examination; FAST, Functional Assessment Staging; MDS-COGS, Minimum Dataset Cognition Scale; va, veterans affairs; DRS, Dementia Rating Scale; CPS, Cognitive Performance Scale; AMT, Abbreviated Mental Test; CDR-C, Clinical Dementia Rating Scale-Chinese Version; Dem-RS2, Dementia Rating Scale 2; SD, Standard Deviation; BEHAVE-AD, Behavioural Pathology in Alzheimer’s disease.
  2. **Based on checklists from van der Windt et al. [52,53] Higher scores indicate higher quality (range observational studies 0–12, range longitudinal studies 0–14) Observational studies that scored ≥10 point were considered ‘high quality’. Longitudinal studies that scored ≥12 points were considered ‘high quality’.