Recently, the number of studies focusing on pain in dementia has increased considerably.
Still, little attention has been paid to the influence of the neuropathology of different dementia subtypes
on pain experience.
In 2003, a review identified several studies that indicated a relation between dementia subtype and
pain experience. Now, ten years later, an update is warranted. We conducted a systematic review to
identify studies that assessed pain experience and dementia subtypes by searching PubMed, Embase,
PsycINFO, CINAHL, and Cochrane Library. Inclusion criteria were: (1) major dementia subtype diagnosis
i.e. Alzheimer’s dementia (AD), vascular dementia (VaD), frontotemporal dementia (FTD),
dementia with Lewy Bodies (DLB); (2) age ≥60 years; and (3) pain experience. We identified twelve
studies that addressed AD, three studies VaD, one study FTD, and no studies DLB.
In AD, studies on clinical pain indicate a reduced pain experience compared to controls, whereas experimental
studies show inconsistent findings. In VaD, clinical studies found that primary caregivers
rated pain equal to cognitively intact controls, although more painful locations were reported. During
self-report, elderly with VaD reported higher pain levels than cognitively intact controls. In FTD, a
significantly lower pain sensitivity to experimental pain was found.
Considering the limited number of studies, these findings should be considered with caution. Existing
literature provides some evidence that dementia subtype affects pain experience. Further research is
needed to clarify the relation between dementia subtype and pain experience as it could serve as basis
for improving the assessment and management of pain in people with dementia.