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Pain in Dementia

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Handbook on the Neuropsychology of Aging and Dementia

Part of the book series: Clinical Handbooks in Neuropsychology ((CHNEURO))

Abstract

Pain is highly prevalent in the elderly, and that prevalence increases as people age, with 25–65% of the elderly and upward of 80% of those in an institutionalized setting experiencing chronic pain. Despite this, pain remains consistently under-evaluated and untreated in the elderly. This issue becomes particularly acute in populations with dementia where cognitive difficulties impair individuals’ ability to communicate their experience of pain. Further, behaviors that are indicative of pain are often attributed to be symptoms of dementia, leaving them either untreated or treated with medications that are likely to be ineffective and/or potentially sedating. Neuropsychologists are in a uniquely qualified position to evaluate pain in dementia populations given their understanding of the cognitive and emotional factors that shape how pain is expressed. Furthermore, given the impact that undertreated pain can have on an individual with dementia, the assessment of pain during a neuropsychological evaluation should serve as the rule rather than the exception. The current chapter provides an overview of pain and its impact on those with dementia. A broad discussion of pain assessment is followed by a more detailed approach to the assessment of pain in dementia and the role that cognition will have on how the assessment should be conducted. A brief discussion of treatment approaches for pain in dementia populations is also included. The chapter is concluded by a discussion of the role of neuropsychologists in the assessment of pain.

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Author information

Authors and Affiliations

  1. Baptist Behavioral Health, Baptist Medical Center, Jacksonville, FL, USA

    Rachel K. Bieu

  2. Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA

    Joseph F. Kulas

  3. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA

    Joseph F. Kulas

Authors
  1. Rachel K. Bieu
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  2. Joseph F. Kulas
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Corresponding author

Correspondence to Joseph F. Kulas .

Editor information

Editors and Affiliations

  1. Department of Neurology, Weill Cornell Medicine, New York, NY, USA

    Lisa D. Ravdin

  2. Department of Neurology, University of Miami, Miami, FL, USA

    Heather L. Katzen

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Bieu, R.K., Kulas, J.F. (2019). Pain in Dementia. In: Ravdin, L.D., Katzen, H.L. (eds) Handbook on the Neuropsychology of Aging and Dementia. Clinical Handbooks in Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-93497-6_20

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