Table 5 Correlates of pain with neuropsychiatric symptoms
Correlates of pain and Specified NPS | Â | ||||
|---|---|---|---|---|---|
First author | N | Pain: prevalence | Neuropsychiatric symptoms: prevalence | Correlates of pain with NPS | Quality of study |
Ahn 2013 [ 36 ] | 56577 | Not reported | Wandering 9% | AOR 0.77 (95% CI: 0.73-0.81) with wandering Subsample without psychotropic medication AOR 0.72 (95% CI: 0.63-0.83) with wandering (Adjusted for cognition, ADL, sociodemographics) | 10 |
Kunik 2005 [ 34 ] | 99 | Pain mean 2.4 (SD 1.2) | Delusions/hallucinations mean 0.35 (SD 0.48) | r=0.15 (p>0.05) with psychosis | 8.5 |
Leong 2007 [ 35 ] | 225 | Pain 44%, chronic pain 34% | Anxiety 48% | SOR 1.8 (95% CI: 1.0-3.0) with anxiety | 8.5 |
Norton 2010 [ 42 ] | 161 | Not reported | BEHAVE-AD mean 6..4 (SD 29.2) RMBPC-NH mean 1.45 (SD 0.64) | r=0.15 (p=0.08) for pain intensity and emotional behaviour problems r=0.05 (p=0.58) for pain intensity and resistiveness to care | 9 |
Torvik 2010 [ 52 ] | 106 | Current pain in total group 55%, in cognitive impaired group 52% | Negative affect index (DQoL) mean 2.0 (SD 0.75), positive affect/humour index (DQoL) mean 3.4 (SD 0.9) | p<0.01 for current pain and negative affect p=0.11 for current pain and with positive affect/humour | 6.5 |
Tosato 2012 [ 3 ] | 2822 | Any pain 19% (moderate/severe/excruciating pain 13%) | Behavioural symptoms 37% Psychiatric symptoms 21% | AOR=0.74 (95% CI: 0.55-1.0) with wandering AOR=1.4 (95% CI: 1.08-1.8) with resistance to care AOR 1.5 (95% CI: 1.07-2.03) with delusions AOR 1.06 (95% CI: 0.80-1.41) with verbal abuse AOR 1.08 (95% CI: 0.75-1.55) with physical abuse (Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition) | 11.5 |
Volicer 2009 [ 37 ] | 929 | Daily pain 29%, less than daily pain 19% | Verbally abusive not easily altered 2%, physically abusive not easily altered 12%, Delusions 8%, Hallucinations 9% | r=0.07 (p=0.03) for pain frequency and verbal abuse AOR=0.9(p=0.53) with resisting care AOR=0.7 (p=1.2) with verbal abuse AOR=0.7 (p=0.16) with physical abuse (Both multivariate models among others controlled for resisting care.) | 11 |
Zieber 2005 [ 38 ] | 58 | Not reported | Not reported | r=0.46 (p<0.01) for DS-DAT scores and resisting care r=0.42 (p<0.01) for DS-DAT scores and aberrant vocalization Pain rating by palliative care nurse consultants: r=0.51 (p<0.01) with resisting care r=0.40 (p<0.01) with aberrant vocalizations Pain rating by facility nurse: r=0.48 (p<0.01) with resisting care r=0.065 (p<0.63) with aberrant vocalizations | 8 |
Correlates of pain and Unspecified NPS | |||||
Black 2006 [ 39 ] | 123 | Pain 63% | Psychiatric disorders or behaviour problems 85%, behaviour problems 67% | SOR 1.9 (95% CI: 0.7-5.3) with psychiatric/ behaviour problems SOR 1.2 (95% CI: 0.5-2.5) with behaviour problems | 6.5 |
Brummel-Smith 2002 [ 40 ] | 104 (excluding those unable to self-report pain) | Moderate-severe pain 60% No-mild pain 40% 50 subject unable to answer | ≥1 disruptive behaviours (wandering, verbal disruption, physical aggression, regressive behaviour, hallucinations) 70% in dementia sample n=154 | SOR 1.8 (95% CI: 0.8-4.0) with ≥1 disruptive behaviour | 7 |
Cipher 2004 [ 4 ] | 234 | Persistent pain 72% | Dysfunctional behaviours mean 4.4 (SD 0.76) | r=0.22 (p<0.05) with dysfunctional behaviours | 7.5 |
Cipher 2006 [ 41 ] | 277 | Acute pain 29% Chronic pain 59% | - | r=0.18 (p<0.05) with GLDS mean behavioural intensity | 7.5 |
Norton 2010 [ 42 ] | 161 | Not reported | BEHAVE-AD mean 61.4 (SD 29.2) RMBPC-NH mean 1.45 (SD 0.64) | r=0.18 (p=0.03) for pain intensity and disruptive behaviour problems | 9 |
r=0.05 (p=0.53) for pain intensity and global need driven behaviours | |||||
2012 [ 3 ] | 2822 | Any pain 19% (moderate/severe/excruciating pain 13%) | Behavioural symptoms 37% Psychiatric symptoms 21% | AOR=1.4 (95% CI: 1.04-1.8) with socially inappropriate behaviour (Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition) | 11.5 |
Williams 2005 [ 39 ] | 331 | Pain 21%, in nh 23%, in rc/al 20% (self-report for subgroup mmse>10 was higher: 39% and 25%) | Behavioural symptoms 58% | OR=1.1 (95% CI: 0.49-2.29) and AOR=1.2 (95% CI: 0.57-2.36) with behavioural symptoms | 10 |
(Adjusted for: sex, race, age, cognitive status, number of 10 comorbidities, impairments of 7 activities of daily living) | |||||