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Table 4 Correlates of pain with agitation/aggression

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

First author N Pain: prevalence Agitation/aggression: prevalence Correlates of pain with agitation/aggression Quality of study
Ahn 2013 [ 36 ] 56577 Not reported Aggression 24% Agitation 24% AOR 1.04 (95% CI: 1.01-1.08) with aggression AOR 1.17 (95% CI: 1.13-1.20) with agitation Subsample without use of psychotropic medication AOR 1.07 (95% CI: 1.01-1.15) with aggression AOR 1.16 (95% CI: 1.08-1.25) with agitation (Adjusted for cognition, ADL, sociodemographics) 10
Bartels 2003 [ 8 ] 1836 Pain 27% Agitation 44%, SOR 1.1 (95% CI: 0.9-1.4) with agitation 4
Kunik 2005 [ 34 ] 99 Pain mean 2.4 (SD 1.2) Agitation (CMAI) mean 14.3 (SD 4.1) r=0.20 (p≤0.05) with aggression 8.5
Leonard 2006 [ 50 ] 103344 Pain 24%; mild pain 15%, moderate to severe pain 9% Physical aggression 7% SOR 0.8 (95% CI: 0.8-0.9) for pain burden and physical aggression 9
Morgan 2012 [ 47 ] 171 Worst pain mean 1.91 (SD 1.53) Non aggressive physical agitation (CMAI) mean 12.14 (SD 4.50) Baseline: r = 0.06 (n.s.) with aggression Follow-up: depression indirectly predicted onset of aggression, through pain 9.5
Shega 2005 [ 48 ] 115 Any current pain self-report 32%, caregiver report 53% Agitation (CMAI) mean 46.9 (SD 18.9), For self-report pain no association with agitation (p>0.05) For caregiver pain report p=0.04 with agitation 9.5
Volicer 2011 [ 51 ] 1101 Any pain 49% Agitation (score>0, range 0–5) 76% r=0.22 to 0.26 (p<0.001) with agitation (Range of correlations scores over 4 periods.) Follow-up: Longitudinal changes in agitation scores are related to changes in depression score but not to pain. 12
Zieber 2005 [ 38 ] 58 Not reported Not reported r=0.51 (p<0.01) for DS-DAT scores and agitation (PAS-total) Pain rating by palliative care nurse consultants: r=0.49 (p<0.01) with agitation (PAS-total) Pain rating by facility nurse: r=0.28 (p<0.05) with agitation (PAS-total) 8
  1. Abbreviations: AOR, Adjusted Odds Ratio; ADL, Activities of Daily Living; SOR, Self-Calculated Odds Ratio; SD, Standard Deviation; r, correlation coefficient; n.s, not significant; CMAI, Cohen Mansfield Agitation Inventory; DS-DAT, Discomfort Scale - Dementia of Alzheimer Type; PAS, Pittsburgh Agitation Scale.