Uncontrolled Pain and Risk for Depression and Behavioral Symptoms in Residents With Dementia.
Uncontrolled Pain and Risk for Depression and Behavioral Symptoms in Residents With Dementia.
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DOI：
10.1016/j.jamda.2021.05.010
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发表时间：
2021-10
影响因子：
7.6
通讯作者：
Winterstein AG
中科院分区：
文献类型：
--
作者：
Jenny Wei YJ;Chen C;Fillingim RB;DeKosky ST;Schmidt S;Pahor M;Solberg L;Winterstein AG
Limited cohort studies have assessed the association between uncontrolled pain and risk for behavioral and psychological symptoms of dementia (BPSD). We conducted a longitudinal cohort study to examine whether associations exist between uncontrolled pain and risk for two common BPSD—depression and behavioral symptoms—among long-term care (LTC) residents with Alzheimer disease and related dementia (ADRD). This retrospective cohort study analyzed quarterly data from the 5% Medicare sample linked to Minimum Data Set (MDS) 3.0 between January 1, 2011, and December 31, 2015. LTC residents aged 50 years or older with ADRD who had chronic pain and at least two quarterly MDS 3.0 assessments. LTC residents were followed up quarterly from first observed quarterly MDS 3.0 until first outcome event or last observed quarterly MDS 3.0. Uncontrolled pain was defined as numerical rating scale >4, verbal descriptor scale of moderate or severe pain, or ≥1 pain indicators on the Checklist of Nonverbal Pain Indicators. Depression was defined as ≥10 on the Patient Health Questionnaire 9; behavioral symptoms were defined as the presence of psychotic (delusions or hallucinations) or disruptive behaviors (rejection of care, or physical, verbal, or other aggressive behaviors). Generalized linear models (GLMs) with marginal structural modeling (MSM) stabilized weights were used to examine uncontrolled pain and outcome risk. The incidence rate of depression and behavioral symptoms during follow-up was 9.4 and 23.1 per 100 resident-years, respectively. Results from the MSM-GLMs showed that LTC residents with uncontrolled pain had a higher risk than those with controlled pain for developing depression (hazard ratio=1.67, 95% CI=1.54–1.81) and behavioral symptoms (hazard ratio=1.28, 95 CI=1.19–1.37). Uncontrolled pain was associated with elevated risk for depressive and behavioral symptoms in dementia, underscoring the importance of pain assessment and control among LTC residents with ADRD. This cohort study demonstrated that uncontrolled pain is associated with increased risk for depressive and behavioral symptoms, underscoring the importance of pain control in residents with dementia.
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DOI：
10.1016/j.jamda.2020.04.029
发表时间：
2021-01
影响因子：
7.6
作者：
Mehta HB;Kuo YF;Raji M;Li S;Westra J;Goodwin JS
通讯作者：
Goodwin JS
DOI：
10.1016/s0140-6736(17)31363-6
发表时间：
2017-12-16
期刊：
Lancet (London, England)
影响因子：
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作者：
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通讯作者：
Mukadam, Naaheed
影响因子：
4
作者：
Husebo, B. S.;Ballard, C.;Aarsland, D.
通讯作者：
Aarsland, D.
影响因子：
5
作者：
Cole, Stephen R.;Hernan, Miguel A.
通讯作者：
Hernan, Miguel A.
DOI：
10.3233/jad-170532
发表时间：
2017
期刊：
Journal of Alzheimer's disease : JAD
影响因子：
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作者：
Cowan RL;Beach PA;Atalla SW;Dietrich MS;Bruehl SP;Deng J;Wang J;Newhouse PA;Gore JC;Monroe TB
通讯作者：
Monroe TB