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Schmerz bei Demenz

Pain in dementia

  • Pain Clinical Updates
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Zusammenfassung

Die Altersrevolution verändert die Zusammensetzung unserer Gesellschaft. Immer mehr Menschen erreichen ein sehr hohes Alter und haben damit ein größeres Risiko, Schmerz und Demenz zu entwickeln. Schmerz wird gewöhnlich auf verbalem Weg kommuniziert, eine Fähigkeit, die bei Menschen mit Demenz zunehmend verloren geht. In der Folge leiden die Betroffenen unnötigerweise an behandelbarem, aber unerkanntem Schmerz. Die Schmerzerfassung bei Patienten mit Demenz ist eine Herausforderung, wobei die Forschung rasche Fortschritte verzeichnet. Instrumente und Protokolle zur Schmerzerfassung (hauptsächlich Fremdeinschätzungsskalen) wurden in nationale und internationale Leitlinien für die Schmerzerfassung bei älteren Menschen aufgenommen. Für eine effektive Schmerzerfassung ist eine interdisziplinäre Zusammenarbeit von Pflegekräften, Ärzten, Psychologen, Informatikern und Ingenieuren von grundlegender Bedeutung. Auch die Schmerzbehandlung erfolgt bei dieser vulnerablen Patientengruppe bevorzugt interdisziplinär. Nichtmedikamentöse Therapieprogramme wurden überwiegend an jüngeren Populationen ohne Demenz untersucht. Viele dieser Ansätze sind jedoch relativ sicher, haben sich als wirksam erwiesen und sollten daher in Schmerztherapieprogrammen an erster Stelle stehen. Paracetamol ist ein relativ sicheres und wirksames Analgetikum der ersten Wahl. In Bezug auf die Anwendung von nichtsteroidalen Antirheumatika, Opioiden und Koanalgetika bei Patienten mit Demenz bestehen dagegen zahlreiche Sicherheitsrisiken. Daher werden regelmäßige Kontrollen des Schmerzes wie auch der potenziellen Nebenwirkungen empfohlen. Für eine bessere Orientierung in der Schmerzbehandlung bei Demenz ist weitere Forschung notwendig.

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Authors and Affiliations

  1. Department of Public Health and Primary Care, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, Niederlande

    Wilco Achterberg

  2. Physiologische Psychologie, Universität Bamberg, Bamberg, Deutschland

    Stefan Lautenbacher

  3. Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, Faculty of Medicine, University of Bergen, Bergen, Norwegen

    Bettina Husebo & Ane Erdal

  4. University of Iowa College of Nursing, Iowa City, IA, USA

    Keela Herr

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Correspondence to Wilco Achterberg.

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W. Achterberg, S. Lautenbacher, B. Husebo, A. Erdal und K. Herr geben an, dass kein Interessenkonflikt besteht.

Übersetzung: Ansgar Schlichting

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Deutsche Fassung von: Achterberg W, Lautenbacher S, Husebo B, Erdal A, Herr K (2020) Pain in dementia. Pain Clinical Updates in Pain Reports. PR9 5 (2020) e803. https://doi.org/10.1097/PR9.0000000000000803. Publikation auf Deutsch mit Genehmigung der International Association for the Study of Pain und den Autoren. Verantwortlich: Frau Prof. Dr. C. Sommer, Würzburg

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Achterberg, W., Lautenbacher, S., Husebo, B. et al. Schmerz bei Demenz. Schmerz 35, 130–138 (2021). https://doi.org/10.1007/s00482-020-00501-w

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