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Review
. 2019 Jun;8(1):53-65.
doi: 10.1007/s40122-019-0111-7. Epub 2019 Jan 21.

Chronic Pain in the Elderly with Cognitive Decline: A Narrative Review

Luca Cravello  1 , Simona Di Santo  2   3 , Giustino Varrassi  4   5 , Dario Benincasa  6 , Paolo Marchettini  7 , Marina de Tommaso  8 , Jacob Shofany  2 , Francesca Assogna  9 , Daniele Perotta  10 , Katie Palmer  11 , Antonella Paladini  12 , Fulvia di Iulio  2 , Carlo Caltagirone  2
Affiliations
Review

Chronic Pain in the Elderly with Cognitive Decline: A Narrative Review

Luca Cravello et al. Pain Ther. 2019 Jun.

Abstract

The presence of pain in elderly persons with cognitive decline is often neglected, under-reported, underestimated, misdiagnosed and not adequately treated, with consequences that have a strong impact on health, independence in activities of daily living and quality of life. There is no empirical evidence that people with dementia experience less pain; therefore, in patients with severe cognitive impairment the progression of cognitive decline dramatically affects the ability to verbalize the presence of pain. Self-assessment scales are considered the "gold standard" for pain assessment, but the presence of cognitive impairment is likely to reduce the reliability of these measures. Treatment of pain in elderly with cognitive decline or dementia is based on non-pharmacological and pharmacological strategies. Pharmacological treatment should consider physiological changes, high comorbidity and drug interactions that occur frequently in the elderly. This narrative review aims to describe current knowledge, methods of detection and treatment approaches for chronic pain in elderly persons with cognitive deficits.

Keywords: Aging; Alzheimer’s disease; Chronic pain; Dementia; Elderly; Frailty.

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