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Older adults with cognitive impairment may experience altered pain response

June 8, 2015
by Megan Combs, Associate Editor
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Residents living with dementia or other forms of cognitive impairment (CI) may experience heightened pain sensitivity, according to a new research report from PAIN, the official publication of the International Association for the Study of Pain. It was previously thought that those with CI had a reduced sensitivity to pain.

"It appears that those with widespread brain atrophy or neural degeneration ... all show increased pain responses and/or greater pain sensitivity," said Ruth Defrin, PhD, of University of Tel Aviv, Israel, in a press release. This includes those living with autism, cerebral palsy, intellectual disability, traumatic brain injuries and stroke.

Defrin and her colleagues conducted the research by analyzing previous studies on pain responses in people with CI. Many patients with CI have trouble communicating their pain to caregivers, which can make it difficult to diagnose. Because caregivers may not be able to interpret resident pain accurately, the diagnosis may have treated lesser pain when it should have treated more.

However, even adults who are healthy and age normally may also experience increased vulnerability to pain on top of slightly reduced cognitive performance. In this case, pain can lead to more of a cognitive decline and vice versa.

In adults with mild to moderate Alzheimer's disease, studies suggest the experience of pain is elevated, but pain sensitivity in adults with late-stage Alzheimer's is unknown. Defrin and researchers have emphasized the need for multi-method approaches to measuring pain in this group of patients, according to the press release.

Defrin said understanding response to pain in those with CI is "an imperative ethical goal."

Click here to read more in PAIN.

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