Prevalence of pain in nursing home residents with different cognitive and communicative abilities

To determine the prevalence of pain and its impact among nursing homes residents with different cognitive and communication abilities.

Cross-sectional study.

Three nursing homes in Singapore.

Residents aged 65 years and above, without a recent change in their cognitive status.

Self-reports were obtained whenever possible. Pain severity was measured with the Pain Assessment in Advanced Dementia scale (categorized version) among the uncommunicative. Residents were also assessed with the short-form version of the Geriatric Depression Scale, the Cornell Scale for Depression in Dementia, the state portion of the Spielberger State-Trait Anxiety Inventory, and the Human Activities Profile.

Pain prevalence did not differ between the communicative resident with normal cognition (48.7%), mildly impaired cognition (46.5%), or severely impaired cognition (42.9%). However, the latter 2 groups reported more acute pain than those with normal cognition (7.9% to 14.1% vs. 2.5%). Those with impaired cognition reported constant pain more often, reported fewer total sites of pain, and had more frequent and more severe pain. Regardless of cognitive status, 73.3% to 100% of residents had significant scores on depression or anxiety measures when they reported pain-related mood disturbance. Pain-related reduction in activity was associated with a lower Human Activities Profile score. Sixteen of 36 uncommunicative residents had pain on the Pain Assessment in Advanced Dementia and at least 12 of them had significant mood disturbance.

Cognitive status does not affect pain prevalence; however, it affects the chronicity and characteristics of reported pain. Self-report of pain-related mood involvement is associated with significant mood scores.