Differences in Pain Between Alzheimer's Disease and Vascular Dementia in Older Females

老年女性阿尔茨海默氏病和血管性痴呆的疼痛差异

• 批准号: 9851601
• 负责人: RONALD L COWAN
• 金额: $ 13.19万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9851601
• 关键词: Differences; Pain; Between; Alzheimer; Disease

 DESCRIPTION (provided by applicant): Poorly treated pain in older adults with dementia is a critical public health problem. When compared to people without dementia, people with dementia receive less pain medication in the presence of similar pain-related conditions. Gender associated differences in the experience of pain are reported in the literature with women generally experiencing more pain and reporting increased sensitivity. Poorly treated pain leads to many associated symptoms, negatively impacts quality of life, and increases healthcare costs. Exploring the biological reasons for alterations in pain processing is essential to increasing our understanding about pain in older adults with Alzheimer's disease (AD) and Vascular dementia (VaD). The paucity of evidence to support best practice pain management in older adults with different types of dementia places these individuals at risk for poor pain management practices. The goals of this project are to determine AD- or VaD-associated psychophysical and psychosocial differences in the processing of pain in older females. Our pilot data in a sample of 12 male and 12 female (age-matched) cognitively normal older adults (ages 65-81) suggests that in response to thermal pain, females reported decreased sensory thresholds for pain and reduced pain associated unpleasantness. A second pilot sample of observational pain in people with AD and VaD indicated that people with VaD may have more behavioral indicators of pain. Using psychophysics (to measure sensory threshold and affective unpleasantness) we will examine dementia and gender-associated differences in thermal pain processing in a broad range of older adults with AD or VaD (age 66-95). Our overall hypothesis is that specific alterations in experimental thermal pain responses, which reflect differences in central pain processing and are of relevance to clinical pain responsiveness, are associated with dementia subtypes (AD, VaD), and amount of white matter vascular lesion burden. These changes may place women with certain dementia subtypes at increased risk for non-detection of pain following injury, under treatment of pain, development of chronic pain, and poor quality of life at end-of-life. Results from this study will contribute to development of improved targeted pain assessment techniques and pain management approaches.

 描述（由申请人提供）：患有痴呆症的老年人的疼痛治疗不当是一个严重的公共卫生问题。与没有痴呆症的人相比，痴呆症患者在出现类似的疼痛相关症状时接受的止痛药物较少。文献报道了与性别相关的疼痛体验差异，女性通常会经历更多的疼痛并且报告敏感性增加。疼痛治疗不当会导致许多相关症状，对生活质量产生负面影响，并增加医疗费用。探索疼痛处理改变的生物学原因对于加深我们对患有阿尔茨海默病 (AD) 和血管性痴呆 (VaD) 的老年人疼痛的了解至关重要。缺乏证据支持患有不同类型痴呆症的老年人的最佳疼痛管理实践，使这些人面临疼痛管理实践不佳的风险。该项目的目标是确定老年女性疼痛处理过程中与 AD 或 VaD 相关的心理物理和心理社会差异。我们对 12 名男性和 12 名女性（年龄匹配）认知正常的老年人（65-81 岁）样本进行的试点数据表明，在对热痛的反应中，女性报告疼痛感觉阈值降低，并减少与疼痛相关的不愉快感。对 AD 和 VaD 患者观察疼痛的第二个试点样本表明，VaD 患者可能有更多的疼痛行为指标。我们将利用心理物理学（测量感觉阈值和情感不愉快程度）来检查患有 AD 或 VaD 的老年人（66-95 岁）的痴呆症和热痛处理中与性别相关的差异。我们的总体假设是，实验性热痛反应的特定变化反映了中枢疼痛处理的差异，并且与临床疼痛反应性相关，与痴呆亚型（AD、VaD）和白质血管病变负荷量相关。这些变化可能会使患有某些痴呆亚型的女性在受伤后未发现疼痛、接受疼痛治疗、发展为慢性疼痛以及临终时生活质量差的风险增加。这项研究的结果将有助于开发改进的目标 疼痛评估技术和疼痛管理方法。