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Pain and delirium in people with dementia in the acute general hospital setting.
- Source :
- Age & Ageing; Nov2018, Vol. 47 Issue 6, p841-846, 6p, 3 Charts
- Publication Year :
- 2018
-
Abstract
- Background Pain and delirium are common in people with dementia admitted to hospitals. These are often under-diagnosed and under-treated. Pain is implicated as a cause of delirium but this association has not been investigated in this setting. Objective To investigate the relationship between pain and delirium in people with dementia, on admission and throughout a hospital admission. Design Exploratory secondary analysis of observational prospective longitudinal cohort data. Setting Two acute hospitals in the UK. Methodology Two-hundred and thirty participants aged ≥70 years were assessed for dementia severity, delirium ((Confusion Assessment Method (CAM), pain (Pain Assessment in Advanced Dementia (PAINAD)) scale and prescription of analgesics. Logistic and linear regressions explored the relationship between pain and delirium using cross-sectional data. Results Pain at rest developed in 49%, and pain during activity for 26% of participants during their inpatient stay. Incident delirium developed in 15%, of participants, and 42% remained delirious for at least two assessments. Of the 35% of participants who were delirious and unable to self-report pain, 33% of these participants experienced pain at rest, and 56 experienced pain during activity. The odds of being delirious were 3.26 times higher in participants experiencing pain at rest (95% Confidence Interval 1.03–10.25, P = 0.044). Conclusion An association between pain at rest and delirium was found, suggesting pain may be a risk factor for delirium. Since pain and delirium were found to persist and develop during an inpatient stay, regular pain and delirium assessments are required to manage pain and delirium effectively. [ABSTRACT FROM AUTHOR]
- Subjects :
- COGNITION disorders diagnosis
DIAGNOSIS of delirium
DIAGNOSIS of dementia
RISK of delirium
GERIATRIC assessment
ANALGESICS
CONFIDENCE intervals
CRITICAL care medicine
DRUGS
HEALTH facilities
LENGTH of stay in hospitals
HOSPITAL admission & discharge
LONGITUDINAL method
SCIENTIFIC observation
PAIN
PATIENTS
REGRESSION analysis
RESEARCH
SELF-evaluation
PAIN management
LOGISTIC regression analysis
SECONDARY analysis
PAIN measurement
SEVERITY of illness index
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 47
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 132600592
- Full Text :
- https://doi.org/10.1093/ageing/afy112