Health problems and correlates of pain in nursing home residents with advanced dementia

Betty E Black, Thomas Finucane, Alva Baker, David Loreck, David Blass, Linda Fogarty, Hilary Phillips, Linda Hovanec, Cynthia Steele, Peter V Rabins

Research output: Contribution to journalArticle

Abstract

This study describes the health problems and comorbid illnesses of nursing home (NH) residents with advanced dementia (n=123) and identifies correlates of staff-identified pain. Study participants were residents of 3 NHs in Maryland, their surrogate decision makers and their physicians. Residents' cognitive function was assessed at study enrollment, and their medical records were reviewed to identify all health problems/illnesses and use of pain medications during the 6 months before their enrollment. The most prevalent health problems were skin problems (95%), nutrition/hydration problems (85%), psychiatric/behavioral problems (85%), gastrointestinal problems (81%), and infections (80%). Sixty-three percent of residents had recognized pain, and 95% of those residents received pain medications. In a multivariate regression analysis, staff-identified pain was associated with aspiration (P=0.008), peripheral vascular disease (P=0.021), musculoskeletal disorders (P=0.032), higher cognitive function (P=0.013), and use of pain medications, including nonopiates (P=0.004) and the combination of opiates and nonopiates (P=0.001). NH residents with advanced dementia experience a complex mixture of multiple chronic and acute comorbidities. These results suggest the need for clinicians in long-term care facilities to be vigilant in assessing and treating pain, particularly as cognitive function declines in those with advanced dementia.

Original languageEnglish (US)
Pages (from-to)283-290
Number of pages8
JournalAlzheimer Disease and Associated Disorders
Volume20
Issue number4
DOIs
StatePublished - Oct 2006

Fingerprint

Nursing Homes
Dementia
Pain
Health
Cognition
Opiate Alkaloids
Peripheral Vascular Diseases
Long-Term Care
Complex Mixtures
Medical Records
Psychiatry
Comorbidity
Multivariate Analysis
Regression Analysis
Physicians
Skin
Infection

Keywords

  • Comorbidities
  • Dementia
  • End-of-life
  • Nursing home
  • Pain

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Neuroscience(all)

Cite this

Health problems and correlates of pain in nursing home residents with advanced dementia. / Black, Betty E; Finucane, Thomas; Baker, Alva; Loreck, David; Blass, David; Fogarty, Linda; Phillips, Hilary; Hovanec, Linda; Steele, Cynthia; Rabins, Peter V.

In: Alzheimer Disease and Associated Disorders, Vol. 20, No. 4, 10.2006, p. 283-290.

Research output: Contribution to journalArticle

Black, Betty E ; Finucane, Thomas ; Baker, Alva ; Loreck, David ; Blass, David ; Fogarty, Linda ; Phillips, Hilary ; Hovanec, Linda ; Steele, Cynthia ; Rabins, Peter V. / Health problems and correlates of pain in nursing home residents with advanced dementia. In: Alzheimer Disease and Associated Disorders. 2006 ; Vol. 20, No. 4. pp. 283-290.
@article{d3731a48f3e944c1bf56fe4cb58f7afa,
title = "Health problems and correlates of pain in nursing home residents with advanced dementia",
abstract = "This study describes the health problems and comorbid illnesses of nursing home (NH) residents with advanced dementia (n=123) and identifies correlates of staff-identified pain. Study participants were residents of 3 NHs in Maryland, their surrogate decision makers and their physicians. Residents' cognitive function was assessed at study enrollment, and their medical records were reviewed to identify all health problems/illnesses and use of pain medications during the 6 months before their enrollment. The most prevalent health problems were skin problems (95{\%}), nutrition/hydration problems (85{\%}), psychiatric/behavioral problems (85{\%}), gastrointestinal problems (81{\%}), and infections (80{\%}). Sixty-three percent of residents had recognized pain, and 95{\%} of those residents received pain medications. In a multivariate regression analysis, staff-identified pain was associated with aspiration (P=0.008), peripheral vascular disease (P=0.021), musculoskeletal disorders (P=0.032), higher cognitive function (P=0.013), and use of pain medications, including nonopiates (P=0.004) and the combination of opiates and nonopiates (P=0.001). NH residents with advanced dementia experience a complex mixture of multiple chronic and acute comorbidities. These results suggest the need for clinicians in long-term care facilities to be vigilant in assessing and treating pain, particularly as cognitive function declines in those with advanced dementia.",
keywords = "Comorbidities, Dementia, End-of-life, Nursing home, Pain",
author = "Black, {Betty E} and Thomas Finucane and Alva Baker and David Loreck and David Blass and Linda Fogarty and Hilary Phillips and Linda Hovanec and Cynthia Steele and Rabins, {Peter V}",
year = "2006",
month = "10",
doi = "10.1097/01.wad.0000213854.04861.cc",
language = "English (US)",
volume = "20",
pages = "283--290",
journal = "Alzheimer Disease and Associated Disorders",
issn = "0893-0341",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Health problems and correlates of pain in nursing home residents with advanced dementia

AU - Black, Betty E

AU - Finucane, Thomas

AU - Baker, Alva

AU - Loreck, David

AU - Blass, David

AU - Fogarty, Linda

AU - Phillips, Hilary

AU - Hovanec, Linda

AU - Steele, Cynthia

AU - Rabins, Peter V

PY - 2006/10

Y1 - 2006/10

N2 - This study describes the health problems and comorbid illnesses of nursing home (NH) residents with advanced dementia (n=123) and identifies correlates of staff-identified pain. Study participants were residents of 3 NHs in Maryland, their surrogate decision makers and their physicians. Residents' cognitive function was assessed at study enrollment, and their medical records were reviewed to identify all health problems/illnesses and use of pain medications during the 6 months before their enrollment. The most prevalent health problems were skin problems (95%), nutrition/hydration problems (85%), psychiatric/behavioral problems (85%), gastrointestinal problems (81%), and infections (80%). Sixty-three percent of residents had recognized pain, and 95% of those residents received pain medications. In a multivariate regression analysis, staff-identified pain was associated with aspiration (P=0.008), peripheral vascular disease (P=0.021), musculoskeletal disorders (P=0.032), higher cognitive function (P=0.013), and use of pain medications, including nonopiates (P=0.004) and the combination of opiates and nonopiates (P=0.001). NH residents with advanced dementia experience a complex mixture of multiple chronic and acute comorbidities. These results suggest the need for clinicians in long-term care facilities to be vigilant in assessing and treating pain, particularly as cognitive function declines in those with advanced dementia.

AB - This study describes the health problems and comorbid illnesses of nursing home (NH) residents with advanced dementia (n=123) and identifies correlates of staff-identified pain. Study participants were residents of 3 NHs in Maryland, their surrogate decision makers and their physicians. Residents' cognitive function was assessed at study enrollment, and their medical records were reviewed to identify all health problems/illnesses and use of pain medications during the 6 months before their enrollment. The most prevalent health problems were skin problems (95%), nutrition/hydration problems (85%), psychiatric/behavioral problems (85%), gastrointestinal problems (81%), and infections (80%). Sixty-three percent of residents had recognized pain, and 95% of those residents received pain medications. In a multivariate regression analysis, staff-identified pain was associated with aspiration (P=0.008), peripheral vascular disease (P=0.021), musculoskeletal disorders (P=0.032), higher cognitive function (P=0.013), and use of pain medications, including nonopiates (P=0.004) and the combination of opiates and nonopiates (P=0.001). NH residents with advanced dementia experience a complex mixture of multiple chronic and acute comorbidities. These results suggest the need for clinicians in long-term care facilities to be vigilant in assessing and treating pain, particularly as cognitive function declines in those with advanced dementia.

KW - Comorbidities

KW - Dementia

KW - End-of-life

KW - Nursing home

KW - Pain

UR - http://www.scopus.com/inward/record.url?scp=33845461910&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845461910&partnerID=8YFLogxK

U2 - 10.1097/01.wad.0000213854.04861.cc

DO - 10.1097/01.wad.0000213854.04861.cc

M3 - Article

C2 - 17132974

AN - SCOPUS:33845461910

VL - 20

SP - 283

EP - 290

JO - Alzheimer Disease and Associated Disorders

JF - Alzheimer Disease and Associated Disorders

SN - 0893-0341

IS - 4

ER -