Featured Research

from universities, journals, and other organizations

Pain relievers could calm dementia patients, study suggests

Date:
September 12, 2011
Source:
The Research Council of Norway
Summary:
Many dementia patients are being treated with antipsychotic medications, but a new study by researchers in Norway and the UK shows that simple pain relievers may be a better alternative.

Many dementia patients are being treated with antipsychotic medications, but a new study shows that simple pain relievers may be a better alternative.

Nearly one in five patients in the study became significantly less agitated and aggressive after treatment with painkillers. The project is a collaborative effort between researchers in Norway and England.

Pain management for aggression and agitation

The study included 352 patients with moderate to serious dementia who exhibited significant behavioural problems such as aggression and agitation. During the eight-week study, all patients received their usual treatment, but half of them received pain treatment in addition.

Agitation is a common symptom of dementia; patients can become anxiety-ridden, upset and short-tempered. Many receive antipsychotic medications intended to reduce their behavioural disturbances, but antipsychotics have a powerful sedative effect and can even exacerbate other dementia symptoms and increase the risk of stroke.

Pain leads to aggressiveness

"The improvement the patients experienced was greater than would have been expected from treatment with antipsychotics," says Bettina Husebø.

Dr Husebø is carrying out post-doctoral research at the University of Bergen's Department of Public Health and Primary Health Care. The study, which she heads, receives funding from the Research Programme on Health and Care Services (HELSEOMSORG) under the Research Council of Norway.

"We hypothesised that behavioural disturbances in dementia patients are sometimes due to pain," she explains. "These patients cannot always communicate to their caregivers that they are in pain, and aggression and agitation become their way of expressing it."

Recurrence after reduction

In the intervention group, patients who were not already taking pain medication were given paracetamol (acetaminophen). Patients who were already taking some form of analgesic painkiller received low doses of morphine or buprenorphine, while those who appeared to suffer neuropathic pain received an antiepileptic drug.

After the eight weeks, the pain treatment was gradually reduced and the intervention-group patients showed marked improvement. But four weeks later the behavioural disturbances began recurring.

"Some people may explain away these positive results by claiming we further sedated the patients. But throughout the study we took control measurements that showed the activity level (in daily living and cognition) of both groups remained unchanged during the eight weeks of pain management," emphasises Dr Husebø.

"Pain assessment training needed"

She believes the results indicate that pain management should be integrated into the clinical treatment of people with dementia in nursing homes.

"Pain assessment is critical in managing pain properly. In the future we must ensure that all nursing home databases have standardised tools for assessing pain based on observation of the patients. Personnel will need training to use these tools, and routines need to be developed to make certain that the tools are actually employed."

Dr Husebø stresses, however, that pain management is not a complete solution but rather part of a comprehensive plan in which activity and communication are essential elements.

Hawthorne effect triggered

The researchers in the study recorded some behavioural improvement in control-group patients as well, i.e. those who did not receive pain medication. This may be explained by the Hawthorne effect -- that taking part in a study can in itself produce temporary, positive changes.

"The nursing home personnel in the study received good training and follow-up. This enhanced knowledge and awareness of the issue in general," explains Dr Husebø, "which in turn had an impact on all patients, not only those whose treatment was altered."

The results have been published in the British Medical Journal.


Story Source:

The above story is based on materials provided by The Research Council of Norway. The original article was written by Elin Fugelsnes/Else Lie; translation by Darren McKellep/Carol B. Eckmann. Note: Materials may be edited for content and length.


Journal References:

  1. B. S. Husebo, C. Ballard, R. Sandvik, O. B. Nilsen, D. Aarsland. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. BMJ, 2011; 343 (jul15 1): d4065 DOI: 10.1136/bmj.d4065
  2. P. B. Rosenberg, C. G. Lyketsos. Treating agitation in dementia. BMJ, 2011; 343 (jul15 1): d3913 DOI: 10.1136/bmj.d3913

Cite This Page:

The Research Council of Norway. "Pain relievers could calm dementia patients, study suggests." ScienceDaily. ScienceDaily, 12 September 2011. <www.sciencedaily.com/releases/2011/09/110906085147.htm>.
The Research Council of Norway. (2011, September 12). Pain relievers could calm dementia patients, study suggests. ScienceDaily. Retrieved September 30, 2014 from www.sciencedaily.com/releases/2011/09/110906085147.htm
The Research Council of Norway. "Pain relievers could calm dementia patients, study suggests." ScienceDaily. www.sciencedaily.com/releases/2011/09/110906085147.htm (accessed September 30, 2014).

Share This



More Health & Medicine News

Tuesday, September 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How 'Yes Means Yes' Defines Sexual Assault

How 'Yes Means Yes' Defines Sexual Assault

Newsy (Sep. 29, 2014) — Aimed at reducing sexual assaults on college campuses, California has adopted a new law changing the standard of consent for sexual activity. Video provided by Newsy
Powered by NewsLook.com
Scientists May Have Found An Early Sign Of Pancreatic Cancer

Scientists May Have Found An Early Sign Of Pancreatic Cancer

Newsy (Sep. 29, 2014) — Researchers looked at 1,500 blood samples and determined people who developed pancreatic cancer had more branched chain amino acids. Video provided by Newsy
Powered by NewsLook.com
Colo. Doctors See Cluster of Enterovirus Cases

Colo. Doctors See Cluster of Enterovirus Cases

AP (Sep. 29, 2014) — Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com
Dr.'s Unsure of Cause of Fast-Spreading Virus

Dr.'s Unsure of Cause of Fast-Spreading Virus

AP (Sep. 29, 2014) — Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins