Sources of Discomfort in Persons With Dementia | Dementia and Cognitive Impairment | JAMA Internal Medicine | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.170.64.36. Please contact the publisher to request reinstatement.
1.
Buffum  MD, Sands  L, Miaskowski  C, Brod  M, Washburn  A.  A clinical trial of the effectiveness of regularly scheduled versus as-needed administration of acetaminophen in the management of discomfort in older adults with dementia.  J Am Geriatr Soc. 2004;52(7):1093-1097.PubMedGoogle ScholarCrossref
2.
Hurley  AC, Volicer  BJ, Hanrahan  PA, Houde  S, Volicer  L.  Assessment of discomfort in advanced Alzheimer patients.  Res Nurs Health. 1992;15(5):369-377.PubMedGoogle ScholarCrossref
3.
Cohen-Mansfield  J, Thein  K, Marx  MS, Dakheel-Ali  M, Freedman  L.  Efficacy of nonpharmacologic interventions for agitation in advanced dementia: a randomized, placebo-controlled trial.  J Clin Psychiatry. 2012;73(9):1255-1261.PubMedGoogle ScholarCrossref
4.
Folstein  MF, Folstein  SE, McHugh  PR.  Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Oxford, England: Pergamon Press; 1975.
5.
Cohen-Mansfield  J.  Pain assessment in noncommunicative elderly persons-PAINE.  Clin J Pain. 2006;22(6):569-575.PubMedGoogle ScholarCrossref
6.
Cohen-Mansfield  J, Lipson  S.  The utility of pain assessment for analgesic use in persons with dementia.  Pain. 2008;134(1-2):16-23.PubMedGoogle ScholarCrossref
Research Letter
July 22, 2013

Sources of Discomfort in Persons With Dementia

Author Affiliations
  • 1Minerva Center for the Interdisciplinary Study of End of Life, Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine and Herczeg Institute on Aging, Tel-Aviv University, Israel
  • 2Innovative Aging Research, Silver Spring, Maryland
JAMA Intern Med. 2013;173(14):1378-1379. doi:10.1001/jamainternmed.2013.6483

Current methods to assess discomfort often include ratings scales, such as the discomfort scale for Alzheimer disease, which are also used to assess pain.1,2 In this study, we take an alternative approach in which we examine the discomfort in the context of its source.

Participants included 179 agitated nursing home residents with dementia (mean age, 86 years; 72% female; mean Mini-Mental State Examination [MMSE] score, 8.79) from 10 nursing homes in Maryland. Residents’ discomfort was observed as part of the study for the Treatment Routes for Exploring Agitation (TREA) that received institutional review board approval of Charles E. Smith Life Communities.3

×