TY - JOUR
T1 - Dementia and response to pain in the elderly
AU - Porter, Fran Lang
AU - Malhotra, Kristen M.
AU - Wolf, Cynthia M.
AU - Morris, John C.
AU - Miller, J. Philip
AU - Smith, Marcia C.
N1 - Funding Information:
We wish to acknowledge the physicians and staff of the ADRC Clinical Core for providing diagnostic and severity information about the ADRC sample and the ADRC Psychometric Core for providing psychometric testing (5P50 AG05681). We also acknowledge the support of the General Clinical Research Center at Washington University for their nursing support (MO1 RR00036). This research was also supported by NIA grants AG03991, AG05681, and AG06815.
PY - 1996/12
Y1 - 1996/12
N2 - To investigate the effect of dementia on response to pain, 51 community-dwelling, generally healthy, cognitively intact individuals ≤ 65 years old and 44 community- or nursing home-dwelling persons ≤ 65 years old with varying severity of dementia were studied. Cognitive status was assessed by standardized clinical evaluation and psychometric test performance. The following responses were measured before, during and after a standard venipuncture procedure: heart rate, the amplitude of respiratory sinus arrhythmia (RSA), self-reported anxiety and pain, and videotaped facial expressions. Although RSA did not differentiate procedural phases, in both samples, mean heart rate increased in the preparatory phase and decreased in the venipuncture phase. Independent of age, increasing severity of dementia was associated with blunting of physiologic response as measured by diminished heart rate increase in the preparatory phase and heart rate increase with venipuncture. Dementia significantly interfered with the subjects' ability to respond to direct questions about anxiety and pain. Those who were able to respond were relatively accurate self-assessors: higher anxiety was associated with greater magnitude heart rate responses. Facial expression was increased in demented individuals but it could not be classified by specific emotions. We conclude that dementia influences both the experience and reporting of pain in elderly individuals.
AB - To investigate the effect of dementia on response to pain, 51 community-dwelling, generally healthy, cognitively intact individuals ≤ 65 years old and 44 community- or nursing home-dwelling persons ≤ 65 years old with varying severity of dementia were studied. Cognitive status was assessed by standardized clinical evaluation and psychometric test performance. The following responses were measured before, during and after a standard venipuncture procedure: heart rate, the amplitude of respiratory sinus arrhythmia (RSA), self-reported anxiety and pain, and videotaped facial expressions. Although RSA did not differentiate procedural phases, in both samples, mean heart rate increased in the preparatory phase and decreased in the venipuncture phase. Independent of age, increasing severity of dementia was associated with blunting of physiologic response as measured by diminished heart rate increase in the preparatory phase and heart rate increase with venipuncture. Dementia significantly interfered with the subjects' ability to respond to direct questions about anxiety and pain. Those who were able to respond were relatively accurate self-assessors: higher anxiety was associated with greater magnitude heart rate responses. Facial expression was increased in demented individuals but it could not be classified by specific emotions. We conclude that dementia influences both the experience and reporting of pain in elderly individuals.
UR - http://www.scopus.com/inward/record.url?scp=0030457427&partnerID=8YFLogxK
U2 - 10.1016/S0304-3959(96)03210-1
DO - 10.1016/S0304-3959(96)03210-1
M3 - Article
C2 - 9121831
AN - SCOPUS:0030457427
SN - 0304-3959
VL - 68
SP - 413
EP - 421
JO - Pain
JF - Pain
IS - 2-3
ER -