ArticleJournal of the American Medical Directors Association2021
Uncontrolled Pain and Risk for Depression and Behavioral Symptoms in Residents With Dementia.
Article in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between pain and behavioral and psychological symptoms of dementia (BPSD) in older adults with dementia: a systematic review and meta-analysis.BMC geriatrics · 2025Pooled it
- A systematic review of opioid prevalence in Australian residential aged care facilities.Australasian journal on ageing · 2022Pooled it
- Physician Antipsychotic Overprescribing Letters and Cognitive, Behavioral, and Physical Health Outcomes Among People With Dementia: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2024Trial
- Risk of Seizure Associated With Concomitant Use of Tramadol and Antidepressants in Older Nursing Home Residents.Neurology · 2025Article
- Ranking Nursing Diagnoses by Predictive Relevance for Intensive Care Unit Transfer Risk in Adult and Pediatric Patients: A Machine Learning Approach with Random Forest.Healthcare (Basel, Switzerland) · 2025Article
- Association of initiating CYP2D6-metabolized opioids with risks of adverse outcomes in older adults receiving antidepressants: A retrospective cohort study.PLoS medicine · 2025Article
- Towards a more equitable future: development, implementation, and evaluation of a novel e-course on racial disparities in pain management for medical students.BMC medical education · 2025Article
- Unrelieved pain and risk of opioid use disorder or overdose in older adults prescribed opioids.Pain · 2025Article
- Mechanisms of comorbidity between Alzheimer's disease and pain.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- Comparison of opioid use among long-term care residents in Ontario and Alberta, Canada: A multi-jurisdictional, repeated cross-sectional study.Canadian journal of pain = Revue canadienne de la douleur · 2025Article
- Minimising Harm and Managing Pain: Deprescribing Opioids in Older Adults.Drugs & aging · 2024Review
- Short- and long-term safety of discontinuing chronic opioid therapy among older adults with Alzheimer's disease and related dementia.Age and ageing · 2024Article
- Pain intensity, physical function, and depressive symptoms associated with discontinuing long-term opioid therapy in older adults with Alzheimer's disease and related dementias.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Quality of Nursing Homes Among ADRD Residents Newly Admitted From the Community: Does Race Matter?Journal of the American Medical Directors Association · 2023Article
- Self-perceived care needs and quality of life in people with cognitive impairment during routine care at home: cross-sectional results of the interventional study.BMC geriatrics · 2023Article
- Did the COVID-19 Pandemic Affect the Use of Antipsychotics Among Nursing Home Residents With ADRD?The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023Observational
- Observational
- Impact of behavioral and psychological symptoms of Alzheimer's disease on caregiver outcomes.Scientific reports · 2022Article
- Article
- Effect of Auricular Acupressure on Acute Pain in Nursing Home Residents with Mild Dementia: A Single-Blind, Randomized, Sham-Controlled Study.Evidence-based complementary and alternative medicine : eCAM · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesLimited cohort studies have assessed the association between uncontrolled pain and risk for behavioral and psychological symptoms of dementia (BPSDs). We conducted a longitudinal cohort study to examine whether associations exist between uncontrolled pain and risk for 2 common BPSDs-depression and behavioral symptoms-among long-term care (LTC) residents with Alzheimer disease and related dementia (ADRD).
designThis retrospective cohort study analyzed quarterly data from the 5% Medicare sample linked to Minimum Data Set (MDS) 3.0 between January 1, 2011, and December 31, 2015. SETTING AND
participantsLTC residents aged 50 years or older with ADRD who had chronic pain and at least 2 quarterly MDS 3.0 assessments.
methodsLTC residents were followed up quarterly from first observed quarterly MDS 3.0 until first outcome event or last observed quarterly MDS 3.0. Uncontrolled pain was defined as numerical rating scale >4, verbal descriptor scale of moderate or severe pain, or ≥1 pain indicators on the Checklist of Nonverbal Pain Indicators. Depression was defined as ≥10 on the Patient Health Questionnaire 9; behavioral symptoms were defined as the presence of psychotic (delusions or hallucinations) or disruptive behaviors (rejection of care, or physical, verbal, or other aggressive behaviors). Generalized linear models (GLMs) with marginal structural modeling (MSM) stabilized weights were used to examine uncontrolled pain and outcome risk.
resultsThe incidence rate of depression and behavioral symptoms during follow-up was 9.4 and 23.1 per 100 resident-years, respectively. Results from the MSM-GLMs showed that LTC residents with uncontrolled pain had a higher risk than those with controlled pain for developing depression [hazard ratio 1.67, 95% confidence interval (CI) 1.54-1.81] and behavioral symptoms (hazard ratio 1.28, 95% CI 1.19-1.37). CONCLUSIONS AND IMPLICATIONS: Uncontrolled pain was associated with elevated risk for depressive and behavioral symptoms in dementia, underscoring the importance of pain assessment and control among LTC residents with ADRD.
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