Ethical and legal issues in pain research in cognitively impaired older adults

Research involving those with dementia is critical to informing best practices and improving the quality of their lives. Pain research in people with dementia is of particular interest because the prevalence of both dementia and painful conditions increases with age. Considerable evidence exists documenting inadequate assessment and treatment of pain in this vulnerable population. Unfortunately, research that supports best practices for assessing and treating pain in the cognitively impaired is limited with obstacles to conducting research. Obstacles to research in older adults, including those with cognitive impairment, have been highlighted along with an urgent call for increased research to promote quality pain care for all older adults. The aims of this paper are to provide an overview of major ethical challenges that can occur in pain research in cognitively impaired populations and to present potential solutions when preparing study protocols.