Annals of Long Term Care

In elderly long-term care (LTC) residents with cognitive impairment, assessment and management of pain is a challenge due to communication barriers. Although coexistence of pain and cognitive impairment is prevalent in LTC settings, little is known about the relationship between these conditions. In a new study published in the Journal of Pain Research, Allison H. Burfield, RN, PhD, and colleagues from the University of North Carolina, sought to evaluate whether cognitive decline and increased pain are predictive of one another. 

Burfield and colleagues conducted a longitudinal cohort study that included more than 56,000 US nursing home residents (average age, 83 years). They found that their sample data did not confirm the presence of concomitance between pain and cognition; namely, the presence of one measure did not predict the presence of the other measure. However, the authors reported that their findings indicate that pain and cognition exist as contributing aspects of how need-driven behaviors are manifested in and communicated by elders. They also note that the study provides guidance on areas where further assessments are needed, concluding “Future research should be used to link cognition, resident ability to communicate, and levels of pain for significance with quality of life measures like depression, disturbances in gait, weight loss, decreased activity, declines in functional status, or social isolation.” When conducting future investigations in this area, the authors note that additional dimensions of pain should be defined because their study was limited to the items available in the Minimum Data Set, which may not fully represent the spectrum of pain symptoms.