Table 1 Characteristics of the included studies
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 |