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Übersichtsartikel

Pain Assessment and Treatment Challenges in Patients with Dementia

1This article is a modified version of the article „Pain in patients with dementia: An overview of pain assessment and treatment challenges” that will be printed in the Journal of Norsk Epidemiologi.

Published Online:https://doi.org/10.1024/1016-264X/a000078

Pain is likely to be equally prevalent in people with dementia, however, only a small minority are prescribed regular analgesics. This is a key issue since untreated pain leads to reduced quality of life and increases the likelihood of emergence of behavioural and psychological symptoms such as agitation. Better assessment and treatment of pain in this fragile patient group are therefore mandatory. In this context, we reviewed the literature on pain and dementia and summarised the best available evidence regarding the frequency of pain and pain diagnosis. Unfortunately, hardly any randomized, controlled studies of pain treatment efficacy in patients with dementia are available, with the consequence that most pain treatment recommendations are not based on the highest level of evidence.


Herausforderungen bei der Erfassung und Behandlung von Schmerzen bei Patienten mit demenzieller Erkrankung

Schmerz ist bei Personen mit Demenz wahrscheinlich ebenso häufig  wie sonst, jedoch werden nur wenigen Patienten Analgetika verschrieben. Das ist ein zentrales Problem, weil unbehandelte Schmerzen die Entwicklung von Verhaltensstörungen und psychischen Symptomen wie Agitiertheit begünstigen. Eine bessere Messung und Behandlung  von Schmerzen bei diesen besonders gebrechlichen Personen ist daher dringend geboten. In diesem Zusammenhang haben wir die Literatur gesichtet und die bestmögliche Evidenz zur Prävalenz von Schmerzen und das Vorgehen in der Schmerzdiagnostik zusammengestellt. Leider gibt es bislang kaum Studien mit randomisiertem Kontrollgruppendesign, so dass die meisten Empfehlungen zur Schmerzbehandlung bei Demenz nicht höchstes Evidenzniveau aufweisen.

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