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Pain assessment and management in cognitively intact and impaired patients 

Pain assessment and management in cognitively intact and impaired patients
Chapter:
Pain assessment and management in cognitively intact and impaired patients
Source:
Oxford Textbook of Geriatric Medicine (3 edn)
Author(s):

Nele Van Den Noortgate

and Elizabeth Sampson

DOI:
10.1093/med/9780198701590.003.0156

Pain is common in older people, affecting up to 60% of older community-dwelling older persons with and without dementia. Chronic pain has a significant impact on the quality of life of older people. Since pain is often underrecognized in the older population, systematic screening and assessment with appropriate tools for the target population, is recommended. A holistic, multidisciplinary approach may offer meaningful support. There are no neurophysiological arguments that pain perception and tolerance are affected by the ageing process. Dementia does not change the sensory perception of pain but can cause changes in the meaning and recognition of the sensation. It is possible to safely use non-pharmacological treatments and available analgesics, provided the clinician has a good knowledge of the side effects of the treatments. In patients with advanced dementia and patients at the end of life, alternative routes of administration of analgesics should be considered.

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