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Table 6 Correlates of pain with physical function

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

Correlates of pain and ADL or IADL
First author N Pain: prevalence Physical function: prevalence Correlates of pain with ADL or IADL Quality of study
Brummel-Smith 2002 [ 36 ] 104 (excluding those unable to self-report pain) Moderate-severe pain 60%, no-mild pain 40% (50 subject unable to answer) ≥1 ADL limitations 92% in dementia sample (n=154) SOR 1.9 (95% CI: 0.0) with ≥ 1 ADL limitation 7
Cipher 2004 [ 4 ] 234 Persistent pain 72% ADL independency mean 0.09 (SD 0.99) Correlations with GMPI ‘pain and suffering’ r=−0.04 (α>0.05) with ADL independency 7.5
Shega 2005 [ 44 ] 115 Any current pain self-report 32%, caregiver report 53% KATZ mean 8.5 (SD 2.7), IADL mean 15.3 (SD 3.9) For self-report pain No association ADL and IADL (p> 0.05) For caregiver pain report No association with ADL or IADL (p> 0.05) 9.5
Shega 2010 [ 45 ] 5549 Moderate or greater pain: 35.8% Any IADL impairment: 665% OR=1.74 (95% CI: 1.15-2.62) with any iADL impairment (Adjusted for demographics) 9
Torvik 2010 [ 48 ] 106 Current pain in total group 55%, in cognitive impaired group 52% Highly or moderate ADL dependent 36% p=0.20 for current pain and ADL SOR=0.5 (95% CI: 0.2-1.2) for current pain and ADL high/medium v.s. low 6.5
Tosato 2012 [ 3 ] 2822 Any pain 19% (moderate/severe/excruciating pain 13%) No disability 8%, assistance required 43%, dependent 49% SOR 1.0 (95% CI: 0.9-1.2) with ADL-dependent SOR 0.9 (95% CI: 0.75-1.09) with ADL assistance required (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
Correlates of pain and other functional impairments
Black 2006 [ 39 ] 123 Pain 63% Nutrition/hydration problems total sample 85% SOR 1.9 (95% CI: 0.7-5.3) with nutrition/hydration 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 ADL limitations 92% in dementia sample (n=154) SOR 1.6 (95% CI: 0.2) with bladder incontinence 7
D’Astolfo 2006 [ 44 ] 140 Pain 64% (musculoskeletal pain 40%) Use of wheel chair 60% Requires assistance 34% SOR 1.5 (95% CI: 0.7-3.0) with use of wheel chair or bedridden SOR 1.0 (95% CI: 0.5-2.0) with requires assistance (Analyses in sample of no dementia-severe dementia) 7
Lin 2011 [ 46 ] 112 Observed pain 37% (PAINAD >=2) Being restrained 46%; observed care activities: bathing 43%, assisted transfer 31%, self-transfer 26% OR=5.4 (95% CI: 2.3-12.5) and AOR=3.0 (95% CI: 1.0-8.7) with being restrained OR=23.4 (95% CI: 3.0-188) and AOR=19.2 (95% CI: 2.3-162) with bathing OR=29.7 (95% CI: 3.6-242) and AOR=11.3 (95% CI: 1.2-102) with assisted transfer, both compared to self-transfer (Adjusted for gender, age, wound, restraint, tube present in body, recent fall, severity of dementia and type of activity) 12
Williams 2005 [ 43 ] 331 Pain 21%, in nh 23%, in rc/al 20% (self-report for subgroup MMSE>10 was higher: 39% and 25%) Low activity 47%, immobile 12% Low food intake 53% Low fluid intake 51% OR=0.65 (95% CI: 0.38-1.11) and AOR=0.64 (95% CI: 0.37-1.10) with low activity OR=1.1 (95% CI: 0.49-2.29) and AOR=0.8 (95% CI: 0.37-1.69) with immobility OR=1.18 (95% CI: 0.64-2.17) and AOR=1.03 (95% CI: 0.56-1.87) with low food intake OR=1.20 (95% CI: 0.67-2.15) and AOR 1.14 (95% CI: 0.66-1.99) with low fluid intake (Adjusted for: sex, race, age, cognitive status, number of 10 comorbidities, impairments of 7 activities of daily living) 10
  1. Abbreviations: SOR, Self-Calculated Odds Ratio; ADL, Activities of Daily Living; SD, Standard Deviation; r, correlation coefficient; GMPI, Geriatric Multidimensional Pain and Illness Inventory; PAINAD, Pain Assessment in Advanced Dementia; OR, Odds Ratio; AOR, Adjusted Odds Ratio; KATZ, Index of Independence in Activities of Daily Living; IADL, Instrumental Activities of Daily Living; nh, nursing home; rc/al, residential care/assisted living; MMSE, Mini Mental State Examination.