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The surprising link between Dementia and pain

There is a tendency to normalize pain as we become older, meaning that aching and soreness is often seen as an everyday discomfort that should be expected with age. However, through a recent study that spanned more than a decade, researchers have discovered a link between chronic pain and an increased risk for Dementia.


The study, which was published in JAMA Internal Medicine, collected interviews from 10,065 people who were older than 62. Participants were interviewed in 1998 and then again in 2000, when they were asked both times whether they were suffering “persistent pain.” They then tracked participants every other year for a period of 12 years, contacting participants again in 2012. Participants who reported persistent pain in both 1998 and 2000 had a 9 percent more rapid decline in memory performance when they were assessed. The probability of developing Dementia increased 7.7 percent faster in people who had persistent pain compared with those that had no pain. Lead researcher Elizabeth L. Whitlock, M.D., a postdoctoral fellow and clinical instructor in the Department of Anesthesia & Perioperative Care at the University of California, San Francisco was inspired by her own patients to carry out the study. She asserts, “in my clinical experience, patients complain of cognitive changes when they have severe chronic pain”. Whitlock continues, “they don’t feel as sharp as they were before the pain. I was curious about whether objective cognitive testing would bear that out, and what the change in cognition over time would be in someone with pain.” Whitlock and her group of researchers are confident that the study is proof that persistent or chronic pain may help identify patients at risk of Dementia.


Assessing Chronic Pain


Chronic pain can be a common problem among nursing home residents. Uncontrolled pain or suboptimal pain management can decrease residents’ quality of life and lead to worsening of other medical conditions and increase the risk of immobility, falls, and other complications. If clients in your care home are suffering from chronic pain, ensure you do more than simply treat the pain. It is vital to look for a Doctor who will track the pain to its true source and fix the problem. In the meantime, you can purchase supplements such as glucosamine and chondroitin, which have been shown to be as good as Celebrex at relieving pain and easing inflammation. During a direct examination by a Doctor, attention is paid to the patient’s self-report, observation of the patient’s physical symptoms and the patient’s behavioural symptoms, such as agitation, restlessness and resisting care.


However, it is important to pay attention to residents’ perception of pain, as this is the most important factor to consider when deciding whether to contact a Doctor. Staff in your care home should not underestimate the ability of these patients to properly express their pain. An individual’s perception of pain can be determined through verbalization or through a use of a variety of pain scales. A popular method of determining pain is through a numerical self-rating scale. When using a numerical scale, a report of 0 or 1 usually is equivalent to having no pain, while a report of 10 is equivalent to the worst pain the patient has ever experienced. While examining a resident reporting pain, the healthcare provider should assess the characteristics of this individual’s pain and how much is known about the pain, including the frequency or chronicity of pain and any precipitating and alleviating factors. Knowledge of any current and previous pain management approaches is essential to properly develop a plan of care.



How can you lower the risk of Dementia developing?



In addition to addressing the pain of residents, here are a few rules that you can follow to help reduce the risk of Dementia developing in individuals:


1.      Ensure residents do activities that keep their brain active.

Activities that keep the brain active can be games such as puzzles, word searches or crosswords, playing cards or learning something new. Perhaps ask individuals whether they would like to learn a new skill, such as learning another language or exploring a new subject in depth. Keeping clients socially engaged and encouraging group activities can reduce their risk of developing Dementia. Dr Whitlock states, “the brain seems to respond well to brain exercise and that may benefit the patient’s overall cognitive awareness”.


2.  Provide clients with a healthy balanced diet.

A healthy diet has a high proportion of oily fish, fruit, vegetables, unrefined cereals and olive oil, and low levels of red meat and sugar. Such a diet will help reduce your risk of dementia and heart disease, stroke and type 2 diabetes. Ensure elderly residents in your care home cut down on saturated fat such as cakes, biscuits and cheeses. A recent study showed that we may be able to delay dementia by taking care of our brain phagocytes. These are the cells that clean up plaque, dead cells, infections, and other things we don’t want making a mess in our brain. In addition, we know our brain needs fat to thrive, so staying away from those low-fat diets and welcoming fat back into the diet makes your brain happy.


3.      Ensure your clients stay physically active.

Although elderly individuals may not be able to do any strenuous exercise, try and encourage some gentle exercise for at least 30 minutes, five times a week. Regular physical exercise, even if simple and light can rapidly reduce the risk of middle-aged or older adults from developing Dementia.