1
|
Pires IM, Denysyuk HV, Villasana MV, Sá J, Marques DL, Morgado JF, Albuquerque C, Zdravevski E. Development Technologies for the Monitoring of Six-Minute Walk Test: A Systematic Review. SENSORS 2022; 22:s22020581. [PMID: 35062542 PMCID: PMC8782011 DOI: 10.3390/s22020581] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 12/12/2022]
Abstract
In the pandemic time, the monitoring of the progression of some diseases is affected and rehabilitation is more complicated. Remote monitoring may help solve this problem using mobile devices that embed low-cost sensors, which can help measure different physical parameters. Many tests can be applied remotely, one of which is the six-minute walk test (6MWT). The 6MWT is a sub-maximal exercise test that assesses aerobic capacity and endurance, allowing early detection of emerging medical conditions with changes. This paper presents a systematic review of the use of sensors to measure the different physical parameters during the performance of 6MWT, focusing on various diseases, sensors, and implemented methodologies. It was performed with the PRISMA methodology, where the search was conducted in different databases, including IEEE Xplore, ACM Digital Library, ScienceDirect, and PubMed Central. After filtering the papers related to 6MWT and sensors, we selected 31 papers that were analyzed in more detail. Our analysis discovered that the measurements of 6MWT are primarily performed with inertial and magnetic sensors. Likewise, most research studies related to this test focus on multiple sclerosis and pulmonary diseases.
Collapse
Affiliation(s)
- Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
- Correspondence: ; Tel.: +351-966-379-785
| | | | - María Vanessa Villasana
- Centro Hospitalar Universitário da Cova da Beira, 6200-251 Covilhã, Portugal;
- Health Sciences Research Unit: Nursing (UICISA: E), School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (J.S.); (C.A.)
| | - Juliana Sá
- Health Sciences Research Unit: Nursing (UICISA: E), School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (J.S.); (C.A.)
- Faculty of Health Sciences, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
- Centro Hospitalar Universitário do Porto, 4099-001 Oporto, Portugal
| | - Diogo Luís Marques
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | | | - Carlos Albuquerque
- Health Sciences Research Unit: Nursing (UICISA: E), School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (J.S.); (C.A.)
| | - Eftim Zdravevski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, North Macedonia;
| |
Collapse
|
2
|
Olanrewaju O, Stockwell S, Stubbs B, Smith L. Sedentary behaviours, cognitive function, and possible mechanisms in older adults: a systematic review. Aging Clin Exp Res 2020; 32:969-984. [PMID: 32026419 DOI: 10.1007/s40520-019-01457-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 12/18/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity can improve cognitive function of older adults, but the influence of sedentary behaviour on cognition is less clear. This systematic review investigated associations between sedentary behaviour and cognitive function in older adults without dementia, and possible mechanisms involved. METHODS Major databases were searched for studies in English between 01/01/1999 and 31/10/2019. The systematic review followed COSMOS-E guideline and a pre-registered protocol (CRD42019122229). Risk of bias was assessed using NICE Quality appraisal checklist. Findings were narratively synthesized and presented. FINDINGS Eighteen studies comprised of 13 cross-sectional and five longitudinal analyses (n = 40,228). Evidence suggested varied associations between varied sedentary behaviours and cognitive function in older adults. 50% of study analyses did not control for physical activity. 3/18 studies demonstrated associations between higher sedentary levels and lower levels of brain biomarkers, while 1/18 showed auto-regulatory effect in the left hippocampus. Conducting a meta-analysis was not justifiable due to considerable methodological, participant, outcome and exposure heterogeneity. CONCLUSION There is a lack of clarity about the overall and independent association between sedentary behaviour and cognition in older age. Underlying mechanisms are similar to physical activity and probably multi-modal. More studies with robust designs and methodology are needed to confirm effect of sedentary behaviour on cognition.
Collapse
Affiliation(s)
| | | | - B Stubbs
- Positive Ageing Research Institute, FHSCME, Anglia Ruskin University, South London and Maudsley Foundation NHS Trust, London, UK
| | - L Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
3
|
Yang HL, Lin SL. The reasons why elderly mobile users adopt ubiquitous mobile social service. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2018.12.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
4
|
Parry S, Chow M, Batchelor F, Fary RE. Physical activity and sedentary behaviour in a residential aged care facility. Australas J Ageing 2018; 38:E12-E18. [DOI: 10.1111/ajag.12589] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sharon Parry
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Marilyn Chow
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Frances Batchelor
- National Ageing Research Institute Royal Melbourne Hospital Melbourne Victoria Australia
| | - Robyn E Fary
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| |
Collapse
|
5
|
Abstract
Accumulating research in rodents and humans indicates that exercise benefits brain function and may prevent or delay onset of neurodegenerative conditions. In particular, exercise modifies the structure and function of the hippocampus, a brain area important for learning and memory. This review addresses the central and peripheral mechanisms underlying the beneficial effects of exercise on the hippocampus. We focus on running-induced changes in adult hippocampal neurogenesis, neural circuitry, neurotrophins, synaptic plasticity, neurotransmitters, and vasculature. The role of peripheral factors in hippocampal plasticity is also highlighted. We discuss recent evidence that systemic factors released from peripheral organs such as muscle (myokines), liver (hepatokines), and adipose tissue (adipokines) during exercise contribute to hippocampal neurotrophin and neurogenesis levels, and memory function. A comprehensive understanding of the body-brain axis is needed to elucidate how exercise improves hippocampal plasticity and cognition.
Collapse
Affiliation(s)
- C'iana Cooper
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Biomedical Research Center, Baltimore, Maryland 21224
| | - Hyo Youl Moon
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Biomedical Research Center, Baltimore, Maryland 21224
- Institute of Sport Science, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Henriette van Praag
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Biomedical Research Center, Baltimore, Maryland 21224
| |
Collapse
|
6
|
van Alphen HJM, Volkers KM, Blankevoort CG, Scherder EJA, Hortobágyi T, van Heuvelen MJG. Older Adults with Dementia Are Sedentary for Most of the Day. PLoS One 2016; 11:e0152457. [PMID: 27031509 PMCID: PMC4816298 DOI: 10.1371/journal.pone.0152457] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 03/15/2016] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Self-reported data suggest that older adults with dementia are inactive. The purpose of the present study was to objectively assess the physical activity (PA) levels of community-dwelling and institutionalized ambulatory patients with dementia, and to compare with the PA levels of cognitive healthy older adults. METHODS We used actigraphy to assess the PA levels in institutionalized (n = 83, age: 83.0 ± 7.6, Mini-Mental-State Examination (MMSE): 15.5 ± 6.5) and community-dwelling dementia patients (n = 37, age: 77.3 ± 5.6, MMSE-score: 20.8 ± 4.8), and healthy older adults (n = 26, age: 79.5 ± 5.6, MMSE-score: 28.2 ± 1.6). We characterized PA levels based on the raw data and classified <100 counts/min as sedentary behavior. RESULTS Institutionalized dementia patients had the lowest daily PA levels (1.69 ± 1.33 counts/day), spent 72.1% of the day sedentary, and were most active between 8:00 and 9:00 am. Institutionalized vs. community-dwelling dementia patients had 23.5% lower daily PA levels (difference M = 0.52, p = .004) and spent 9.3% longer in sedentariness (difference M = 1.47, p = .032). Community-dwelling dementia patients spent 66.0% of the day sedentary and were most active between 9:00 to 10:00 am with a second peak between 14:00 to 15:00. Community-dwelling dementia patients vs healthy older adults' daily PA levels and sedentary time were 21.6% lower and 8.9% longer, respectively (difference M = 0.61, p = .007; difference M = 1.29, p = .078). CONCLUSIONS Institutionalized and community-dwelling dementia patients are sedentary for most of the day and the little PA they perform is of lower intensity compared to their healthy peers. Their highest PA peak is when they get out of bed in the morning. In addition, it seems that institutionalized living is associated with lower PA levels in dementia patients. These are the first results that objectively characterize institutionalized as well as community-dwelling dementia patients' PA levels and confirm that dementia patients are inactive.
Collapse
Affiliation(s)
- Helena J. M. van Alphen
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Karin M. Volkers
- Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | | | - Erik J. A. Scherder
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke J. G. van Heuvelen
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| |
Collapse
|
7
|
Douma JG, Volkers KM, Vuijk JP, Sonneveld MH, Goossens RHM, Scherder EJA. The effects of observation of walking in a living room environment, on physical, cognitive, and quality of life related outcomes in older adults with dementia: a study protocol of a randomized controlled trial. BMC Geriatr 2015; 15:26. [PMID: 25886987 PMCID: PMC4407293 DOI: 10.1186/s12877-015-0024-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 03/02/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The number of older adults with dementia is expected to increase. Dementia is not only characterized by a decline in cognition, also other functions, for example, physical functioning change. A possible means to decrease the decline in these functions, or even improve them, could be increasing the amount of physical activity. A feasible way hereto may be activation of the mirror neuron system through action observation. This method has already been shown beneficial for the performance of actions in, for example, stroke patients. The primary aim of this study is to examine the effect of observing videos of walking people on physical activity and physical performance, in older adults with dementia. Secondary, effects on cognition and quality of life related factors will be examined. METHODS/DESIGN A cluster randomized controlled trial is being performed, in which videos are shown to older adults with dementia (also additional eligibility criteria apply) in shared living rooms of residential care facilities. Due to the study design, living rooms instead of individual participants are randomly assigned to the experimental (videos of walking people) or control (videos of nature) condition, by means of drawing pieces of paper. The intervention has a duration of three months, and takes place on weekdays, during the day. There are four measurement occasions, in which physical activity, physical functioning, activities of daily living, cognition, the rest-activity rhythm, quality of life, and depression are assessed. Tests for participants are administered by a test administrator who is blind to the group the participant is in. DISCUSSION This study examines the effect of the observation of walking people on multiple daily life functions and quality of life related factors in older adults with dementia. A strength of this study is that the intervention does not require much time and attention from caregivers or researchers. A challenge of the study is therefore to get to know for how long residents watch the videos. However, the design implies a high feasibility of the study, as well as a high applicability of the intervention into daily care. TRIAL REGISTRATION NTR4708. Date of registration: 31 July 2014.
Collapse
Affiliation(s)
- Johanna G Douma
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
| | - Karin M Volkers
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
| | - Jelle Pieter Vuijk
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
| | - Marieke H Sonneveld
- TU Delft, Faculty of Industrial Design Engineering, Landbergstraat 15, 2628, CE, Delft, the Netherlands.
| | - Richard H M Goossens
- TU Delft, Faculty of Industrial Design Engineering, Landbergstraat 15, 2628, CE, Delft, the Netherlands.
- Erasmus MC, Department of Neuroscience, Dr. Molewaterplein 50, 3015, GE, Rotterdam, the Netherlands.
| | - Erik J A Scherder
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
- University of Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713, AV, Groningen, the Netherlands.
| |
Collapse
|
8
|
Bossers WJR, Scherder EJA, Boersma F, Hortobágyi T, van der Woude LHV, van Heuvelen MJG. Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. A pilot study. PLoS One 2014; 9:e97577. [PMID: 24844772 PMCID: PMC4028210 DOI: 10.1371/journal.pone.0097577] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 04/17/2014] [Indexed: 12/13/2022] Open
Abstract
Objectives We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Methods Thirty-three patients with dementia, recruited from one nursing home, participated in this non-randomized pilot study (25 women; age = 85.2±4.9 years; Mini Mental State Examination = 16.8±4.0). In phase 1 of the study, seventeen patients in the Exercise group (EG) received a combined aerobic and strength training program for six weeks, five times per week, 30 minutes per session, in an individually supervised format and successfully concluded the pre and posttests. In phase 2 of the study, sixteen patients in the Social group (SG) received social visits at the same frequency, duration, and format and successfully concluded the pre and posttests. Results Indices of feasibility showed that the recruitment and adherence rate, respectively were 46.2% and 86.3%. All EG patients completed the exercise program according to protocol without adverse events. After the six-week program, no significant differences on cognitive function tests were found between the EG and SG. There was a moderate effect size in favor for the EG for the Visual Memory Span Forward; a visual attention test. There were significant differences between groups in favor for the EG with moderate to large effects for the physical tests Walking Speed (p = .003), Six-Minute Walk Test (p = .031), and isometric quadriceps strength (p = .012). Conclusions The present pilot study showed that it is feasible to conduct a combined aerobic and strength training program in institutionalized patients with dementia. The selective cognitive visual attention improvements and more robust changes in motor function in favor of EG vs. SG could serve as a basis for large randomized clinical trials. Trial Registration trialregister.nl 1230
Collapse
Affiliation(s)
- Willem J. R. Bossers
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- * E-mail:
| | - Erik J. A. Scherder
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- VU University, Department of Clinical Neuropsychology, Amsterdam, The Netherlands
| | - Froukje Boersma
- University of Groningen, University Medical Center Groningen, Department of General Practice, Elderly Care Medicine, Groningen, The Netherlands
| | - Tibor Hortobágyi
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Lucas H. V. van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| | - Marieke J. G. van Heuvelen
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| |
Collapse
|
9
|
Physical performance is associated with working memory in older people with mild to severe cognitive impairment. BIOMED RESEARCH INTERNATIONAL 2014; 2014:762986. [PMID: 24757674 PMCID: PMC3971508 DOI: 10.1155/2014/762986] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/02/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. METHODS This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years). Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. RESULTS The full models explain 49-57% of the variance in working memory and 40-43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3-7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. CONCLUSIONS Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482.
Collapse
|
10
|
Abstract
BACKGROUND This is an update of our previous 2008 review. Several recent trials and systematic reviews of the impact of exercise on people with dementia are reporting promising findings. OBJECTIVES Primary: Do exercise programs for older people with dementia improve cognition, activities of daily living (ADLs), challenging behaviour, depression, and mortality in older people with dementia?Secondary: Do exercise programs for older people with dementia have an indirect impact on family caregivers' burden, quality of life, and mortality?Do exercise programs for older people with dementia reduce the use of healthcare services (e.g. visits to the emergency department) by participants and their family caregivers? SEARCH METHODS We identified trials for inclusion in the review by searching ALOIS (www.medicine.ox.ac.uk/alois), the Cochrane Dementia and Cognitive Improvement Group's Specialised Register, on 4 September 2011, and again on 13 August 2012. The search terms used were: 'physical activity' OR exercise OR cycling OR swim* OR gym* OR walk* OR danc* OR yoga OR 'tai chi'. SELECTION CRITERIA In this review, we included randomized controlled trials in which older people, diagnosed with dementia, were allocated either to exercise programs or to control groups (usual care or social contact/activities) with the aim of improving cognition, ADLs, behaviour, depression, and mortality. Secondary outcomes related to the family caregiver(s) and included caregiver burden, quality of life, mortality, and use of healthcare services. DATA COLLECTION AND ANALYSIS Independently, at least two authors assessed the retrieved articles for inclusion, assessed methodological quality, and extracted data. Data were analysed for summary effects using RevMan 5.1 software. We calculated mean differences or standardized mean difference (SMD) for continuous data, and synthesized data for each outcome using a fixed-effect model, unless there was substantial heterogeneity between studies, when we used a random-effects model. We planned to explore heterogeneity in relation to severity and type of dementia, and type, frequency, and duration of exercise program. We also evaluated adverse events. MAIN RESULTS Sixteen trials with 937 participants met the inclusion criteria. However, the required data from three trials and some of the data from a fourth trial were not published and not made available. The included trials were highly heterogeneous in terms of subtype and severity of participants' dementia, and type, duration and frequency of exercise. Only two trials included participants living at home. Our meta-analysis suggested that exercise programs might have a significant impact on improving cognitive functioning (eight trials, 329 participants; SMD 0.55, 95% confidence interval (CI) 0.02 to 1.09). However, there was substantial heterogeneity between trials (I(2) value 80%), most of which we were unable to explain. We repeated the analysis omitting one trial, an outlier, that included only participants with moderate or severe dementia. This reduced the heterogeneity somewhat (I(2) value 68%), and produced a result that was no longer significant (seven trials, 308 participants; SMD 0.31, 95% CI -0.11 to 0.74). We found a significant effect of exercise programs on the ability of people with dementia to perform ADLs (six studies, 289 participants; SMD 0.68, 95% CI 0.08 to 1.27). However, again we observed considerable unexplained statistical heterogeneity (I(2) value 77%) in this meta-analysis. This means that there is a need for caution in interpreting these findings. In further analyses, we found that the burden experienced by informal caregivers providing care in the home may be reduced when they supervise the participation of the family member with dementia in an exercise program (one study, 40 participants; MD -15.30, 95% CI -24.73 to -5.87), but we found no significant effect of exercise on challenging behaviours (one study, 110 participants; MD -0.60, 95% CI -4.22 to 3.02), or depression (six studies, 341 participants; MD -0.14, 95% CI -0.36 to 0.07) . We could not examine the remaining outcomes, quality of life, mortality, and healthcare costs, as either the appropriate data were not reported, or we did not retrieve trials that examined these outcomes. AUTHORS' CONCLUSIONS There is promising evidence that exercise programs can have a significant impact in improving ability to perform ADLs and possibly in improving cognition in people with dementia, although some caution is advised in interpreting these findings. The programs revealed no significant effect on challenging behaviours or depression. There was little or no evidence regarding the remaining outcomes of interest.
Collapse
Affiliation(s)
- Dorothy Forbes
- Faculty of Nursing, University of Alberta, 3rd Floor, Clinical Sciences Building, Edmonton, Alberta, Canada, T6G 2G3
| | | | | | | | | |
Collapse
|
11
|
Corbett A, Husebo B, Malcangio M, Staniland A, Cohen-Mansfield J, Aarsland D, Ballard C. Assessment and treatment of pain in people with dementia. Nat Rev Neurol 2012; 8:264-74. [PMID: 22487749 DOI: 10.1038/nrneurol.2012.53] [Citation(s) in RCA: 221] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Many elderly people experience pain and regularly take analgesic medication. Pain is also frequent in people with dementia, particularly those with severe disease. As no robust clinical guidelines are available for the treatment of pain in the context of dementia, the risk of inadequate treatment in individuals with this condition is high. Furthermore, our understanding of the aetiology of pain and the potential role of dementia-associated neuropathology in pain is limited. These issues are important in the clinical management of individuals with dementia, as untreated pain is a major contributor to reduced quality of life and disability, and can lead to increased behavioural and psychological symptoms. Assessment scales to identify pain in people with dementia have been highlighted in recent studies, but there is little evidence for consistency between these tools. Numerous studies have evaluated various approaches for the treatment of pain, including stepped-care protocols and/or administration of paracetamol and opioid medications. In this Review, we summarize the best-available evidence regarding the aetiology, assessment and treatment of pain in people with dementia. Further validation of assessment tools and large-scale trials of treatment approaches in people with dementia are needed to improve clinical guidance for the treatment of pain in these individuals.
Collapse
Affiliation(s)
- Anne Corbett
- Alzheimer's Society, 58 St Katharine's Way, London E1W 1LB, UK
| | | | | | | | | | | | | |
Collapse
|