This study aimed to describe the profile of demented elderly individuals and identify the prevalence and characteristics of pain in this population. The study included 60 institutionalized elderly aged 65 and older. Results found that most demented subjects did not express pain according to self-assessment, but hetero-assessment found that 72% experienced pain, with 18.8% having severe pain. The prevalence of pain in demented elderly varies significantly and is often underdiagnosed due to difficulty expressing pain. The study concludes that pain is a significant problem for demented elderly and more research is needed on pain assessment and treatment.

1. Pain assessment in people with dementia
Authors: Feki I , Hentati S , Sellami
Psychiatric Departement University Hospital
Introduction:
Assessing and quantifying the experience of pain in elderly with cognitive impairment is particularly challenging.
Objectives:
To describe the overall profile and to identify the prevalence and characteristics of pain among demented elderly.To describe the overall profile and to identify the prevalence and characteristics of pain among demented elderly.
Methods:
A descriptive study including 60 institutionalized elderly aged 65 and older in the retirement home,
Data collection was conducted using questionnaire exploring sociodemographic
Mini-Mental State Examination (MMSE) and Katz Index of Independence in Activities of Daily Living (ADL) were used to
assess respectively mental status and dependence for ADL.
Verbal Descriptor Scale (VDS) and elderly behavioral scale (ECPA) were used to evaluate pain.
Thirty-two elderly were included and the inclusion criteria were: Age≥65 and MMSE score ≤ 20..
Results: Discussion:Results:
1-Sociodemographic and clinical characteristics :
Average age 74.2 ± 6.5 years
Sex-ratio (♂/♀) 1.28
Marital status
Single 56.3%
Married 3.1%
Divorced 28.1%
Discussion:
1

years. It had a slight predominance of males (56%), which is
different from literature findings that report a feminization of
aging, especially in the very old group(1).

history was found among 84.4% of subjects. Similarly to previous
studies, Socioeconomic features (2), low educational levelDivorced 28.1%
Widower 12.5%
Illiteracy 83%
Antecedents
Medical 84.4%
Surgical 31.3%
Psychiatric 6,3%
Dependance for ADL 65.6%
Average length of stay 4.8 years
studies, Socioeconomic features (2), low educational level
(3), cardiovascular
conditions are frequent and it is considered as a risk factor to
dementia.(4)
2
demented elderly:

demented subjects (93.8%) did not feel and express pain.
Whereas, the hetero evaluation (ECPA) concluded that 72% of
demented elderly had pain with severe pain in 18.8% of cases. A
2-Pain among demented elderly:
*Self-assessment (VDS):
Average length of stay 4.8 years
Reasons of
admission
Voluntarily 68.8%
Neglect 25%
Family conflicts 8.3%
2,2% 1,1% No pain
demented elderly had pain with severe pain in 18.8% of cases. A
finding which is in line with prior research. (5,6)

83%, and is often
those with advanced dementia, who find it difficult to express their
pain, making their evaluation more troublesome. (6)
Conclusion:
Pain in elderly persons with dementia is a significant problem.
This underlines high needs of research as well as excellent
implementation concepts for assessment and treatment of pain
* Hetero-evaluation(ECPA):
93,8%
3%
2,2% 1,1% No pain
Mild pain
Moderate
pain
Sever pain
implementation concepts for assessment and treatment of pain
Bibliogrphy
(
risk factors,”
(2) Alzheimer's Association, “2010 Alzheimer's disease facts and
figures,”
(3) B. L.
aging, demographics, and memory study,”
125
(4) C.
community
642
28,1%
53,1%
18,8%
No pain
Moderate pain
Sever pain
642
(5)
assessment
(6)
older adult.
Pain assessment in people with dementia
Sellami R , Baati I , Masmoudi J.
University Hospital Hédi Chaker Sfax, Tunisia
Assessing and quantifying the experience of pain in elderly with cognitive impairment is particularly challenging.
To describe the overall profile and to identify the prevalence and characteristics of pain among demented elderly.To describe the overall profile and to identify the prevalence and characteristics of pain among demented elderly.
A descriptive study including 60 institutionalized elderly aged 65 and older in the retirement home, Sfax, Tunisia.
sociodemographic and medical data.
Mental State Examination (MMSE) and Katz Index of Independence in Activities of Daily Living (ADL) were used to
Verbal Descriptor Scale (VDS) and elderly behavioral scale (ECPA) were used to evaluate pain.
two elderly were included and the inclusion criteria were: Age≥65 and MMSE score ≤ 20..
Discussion:Discussion:
1-Demented elderly profile:
Our sample comprised old individuals with a mean age of 74
years. It had a slight predominance of males (56%), which is
different from literature findings that report a feminization of
aging, especially in the very old group(1).
Demented elderly were mostly illiterate (83%). A medical
history was found among 84.4% of subjects. Similarly to previous
studies, Socioeconomic features (2), low educational levelstudies, Socioeconomic features (2), low educational level
(3), cardiovascular comorbidity and coexistence of other medical
conditions are frequent and it is considered as a risk factor to
dementia.(4)
2-Prevalence and characteristics of pain among
demented elderly:
In the present study, according to the VDS, the majority of
demented subjects (93.8%) did not feel and express pain.
Whereas, the hetero evaluation (ECPA) concluded that 72% of
demented elderly had pain with severe pain in 18.8% of cases. Ademented elderly had pain with severe pain in 18.8% of cases. A
finding which is in line with prior research. (5,6)
The prevalence of pain in these individuals varies from 49 to
83%, and is often underdiagnosed and undertreated, especially in
those with advanced dementia, who find it difficult to express their
pain, making their evaluation more troublesome. (6)
Conclusion:
Pain in elderly persons with dementia is a significant problem.
This underlines high needs of research as well as excellent
implementation concepts for assessment and treatment of pain.implementation concepts for assessment and treatment of pain.
Bibliogrphy:
(1)N. A. Azad, M. Al Bugami, and I. Loy-English, “Gender differences in dementia
risk factors,” Gender Medicine, vol. 4, no. 2, pp. 120–129, 2007.
(2) Alzheimer's Association, “2010 Alzheimer's disease facts and
figures,” Alzheimer's and Dementia, vol. 6, no. 2, pp. 158–194, 2010.
(3) B. L. Plassman, K.and al, “Prevalence of dementia in the United States: the
aging, demographics, and memory study,” Neuroepidemiology, vol. 29, no. 1-2, pp.
125–132, 2007.
(4) C. Helmer, and al “Mortality with dementia: results from a French prospective
community-based cohort,” American Journal of Epidemiology, vol. 154, no. 7, pp.
642–648, 2001.642–648, 2001.
(5) Hadjistavropoulos T, and al interdisciplinary expert consensus statement on
assessment of pain in older persons. Clin J Pain. 2007;23(1 Suppl):S1–43.
(6) Bjoro K, Herr K. Assessment of pain in the nonverbal or cognitively impaired
older adult. Clin Geriatr Med. 2008;24(2):237–262.