Intersection of pain and behavioural and psychological symptoms of dementia in Alzheimer's disease.

Background: Pain is highly prevalent but challenging to assess in individuals with dementia. Non-cognitive symptoms, such as behavioural and psychological symptoms of dementia (BPSD) and undetected pain, can severely impair functionality and degrade the quality of life for Alzheimer's disease patients. This study aims to examine the relationship between pain and BPSD in patients with Alzheimer's disease.

Methods: A hospital-based, cross-sectional study using a convenience sampling technique was conducted with Alzheimer's disease patients attending an outpatient clinic at a tertiary care geriatric centre. Participants' cognitive impairment was assessed using the Mini-Mental State Examination (MMSE), pain severity was evaluated with the Numeric Rating Scale (NRS) and Pain Assessment in Advanced Dementia (PAIN-AD) scale, and BPSD was measured using the Behavioural Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Over 6 months, 50 participants who met the inclusion and exclusion criteria were included.

Results: The median age of the participants was 69 years, with a median MMSE score of 16. All participants experienced some level of pain and exhibited at least one BPSD. Statistical analysis revealed a significant association between both subjective and objective pain and behavioural and psychological symptoms. A strong correlation was also observed between NRS and PAIN-AD scores with affective disturbances and anxieties.

Conclusion: Common occurrence of pain and BPSD in Alzheimer's disease among the Indian population underscores the importance of pain assessment and management for enhancing patient well-being.