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Pain Cues in People With Dementia: Scoping Review.

Urška Smrke1, Ana Milošič1, Izidor Mlakar1

  • 1Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroška cesta 46, Maribor, 2000, Slovenia, +386 2 220 72 67.

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Summary

Digital monitoring offers a promising approach to objectively detect pain cues in individuals with dementia who struggle to communicate their pain. This review identified key behavioral and physiological indicators for improved pain assessment.

Keywords:
artificial intelligencedementiadigital monitoringpainpain detectionreviewscreeningsymptoms

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Area of Science:

  • Gerontology
  • Medical Informatics
  • Pain Management

Background:

  • Individuals with dementia, particularly in later stages, face challenges in verbally expressing pain.
  • This communication barrier leads to underassessment and undertreatment of pain in this population.
  • Objective pain assessment methods are crucial for improving care for persons with dementia.

Purpose of the Study:

  • To identify observable pain cues suitable for digital pain monitoring in people with dementia.
  • To determine the digital cues that provide valid insights into pain experiences (RQ1).
  • To identify how these pain cues were originally measured in existing research (RQ2).

Main Methods:

  • A scoping review methodology was employed.
  • Relevant research papers were systematically searched using SCOPUS and Web of Science databases.
  • Thematic analysis was used to categorize extracted data on observable pain cues.

Main Results:

  • Out of 3705 identified publications, 34 met the inclusion criteria.
  • Seven categories of behavioral and physiological pain cues were identified, with facial expressions (59%) and body movements (44%) being most frequent.
  • While most studies relied on human observation (85%), a smaller portion incorporated technology like facial recognition or computer vision (15%).

Conclusions:

  • This review compiles a comprehensive list of relevant pain indicators for individuals with dementia.
  • It lays the groundwork for utilizing artificial intelligence and digital monitoring tools for pain screening in dementia care.
  • Objective digital monitoring can enhance the recognition and management of pain in persons with dementia.