Pain and the Alzheimer's Disease and Related Dementia Spectrum in Community-Dwelling Older Americans: A Nationally Representative Study.
Pain and the Alzheimer's Disease and Related Dementia Spectrum in Community-Dwelling Older Americans: A Nationally Representative Study.
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DOI：
10.1016/j.jpainsymman.2022.01.012
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发表时间：
2022-05
影响因子：
4.7
通讯作者：
Li, Yue
中科院分区：
文献类型：
--
作者：
Wang, Jinjiao;Cheng, Zijing;Kim, Yeunkyung;Yu, Fang;Heffner, Kathi L.;Quinones-Cordero, Maria M.;Li, Yue
关键词：
疼痛是阿尔茨海默病和相关痴呆（ADRD）老年人的一个重要问题。检查ADRD谱中认知障碍与社区居住的美国老年人疼痛评估和治疗之间的关联。这项基于人群的横断面研究包括2018年健康与退休研究中16，836名≥ 50岁的社区居住参与者。通过有效的认知测量评估，ADRD被分类为“痴呆”、“认知损害，非痴呆（CIND）”和“完整认知”。疼痛评估包括疼痛存在（经常受到疼痛困扰）、疼痛严重程度（大部分时间疼痛程度[轻度/中度/重度]）和疼痛干扰（疼痛使日常活动难以进行）。疼痛治疗包括近期使用非处方止痛药和阿片类药物（过去3个月），以及定期服用止痛处方。痴呆与报告疼痛存在的可能性较低（比值比[OR]= 0.61，p=0.01）、疼痛干扰（OR=0.46，p<0.001）、报告疼痛严重程度较低（例如，中度与无：相对风险比[RRR]=0.38，p<0.001），接受疼痛治疗的可能性较低，即，近期使用非处方止痛药（OR=0.60，p=0.02）和阿片类药物（OR=0.33，p<0.001），定期服用止痛处方（OR=0.461，p=0.002）。CIND与报告较低的疼痛严重程度相关（例如，中度vs.无：RR =0.75，p=0.021），报告疼痛干扰的可能性较低（OR=0.79，p=0.045）和近期使用非处方止痛药（OR=0.74，p=0.026）。CIND和痴呆增加了疼痛报告不足和治疗不足的风险。需要系统的努力来改善认知障碍老年人的疼痛识别和治疗，无论痴呆症的诊断。
Pain is a significant concern among older adults with Alzheimer’s disease and related dementias (ADRD). Examine the association between cognitive impairment across the ADRD spectrum and pain assessment and treatment in community-dwelling older Americans. This cross-sectional, population-based study included 16,836 community-dwelling participants ≥ 50 years in the 2018 Health and Retirement Study. ADRD, assessed by validated cognitive measures, was categorized into “dementia”, “cognitive impairment, no dementia (CIND)” and “intact cognition”. Pain assessment included pain presence (often being troubled with pain), pain severity (degree of pain most of the time [mild/moderate/severe]), and pain interference (pain making it difficult to do usual activities). Pain treatment included recent use of over-the-counter pain medications and opioids (past 3 months), and regular intake of prescriptions for pain. Dementia were associated with lower likelihood of reporting pain presence (Odds Ratio [OR]= 0.61, p=0.01), pain interference (OR=0.46, p<0.001), reporting lower pain severity (e.g., moderate vs. no: Relative Risk Ratio [RRR]=0.38, p<0.001), and lower likelihood of receiving pain treatment, i.e., recent use of over-the-counter pain medications (OR=0.60, p=0.02) and opioids (OR=0.33, p<0.001), and regular intake of prescriptions for pain (OR=0.461, p=0.002). CIND was associated with reporting lower pain severity (e.g., moderate vs. no: RRR=0.75, p=0.021), lower likelihood of reporting pain interference (OR=0.79, p=0.045) and recent over-the-counter pain medication use (OR=0.74, p=0.026). CIND and dementia increased the risk of under-report and under-treatment of pain. Systematic efforts are needed to improve pain recognition and treatment among older adults with cognitive impairment, regardless of dementia diagnosis.
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影响因子：
6.3
作者：
Bell T;Franz CE;Kremen WS
通讯作者：
Kremen WS
影响因子：
14
作者：
通讯作者：
--
DOI：
10.1016/j.pmn.2020.08.002
发表时间：
2021-04
期刊：
Pain management nursing : official journal of the American Society of Pain Management Nurses
影响因子：
--
作者：
Boltz M;Resnick B;Kuzmik A;Mogle J;Jones JR;Arendacs R;BeLue R;Cacchione P;Galvin JE
通讯作者：
Galvin JE
影响因子：
6.3
作者：
Covinsky KE;Lindquist K;Dunlop DD;Yelin E
通讯作者：
Yelin E
影响因子：
4.7
作者：
Ferrell, BA;Ferrell, BR;Rivera, L
通讯作者：
Rivera, L