Association between pain and behavioral and psychological symptoms of dementia (BPSD) in older adults with dementia: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Behavioral and Psychological Symptoms of Dementia (BPSD) are core and highly detrimental symptoms of dementia. Previous research has suggested a potential association between pain and BPSD, but pieces of evidence are lacking. OBJECTIVE: This study aimed to investigate the association between pain and BPSD in patients with dementia. METHODS: Seven databases were searched from inception to February 2024, including PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang Data. Cross-sectional and longitudinal studies were included. We included studies that involved older adults with dementia and assessed the pain and BPSD by using validated tools. The quality of cohort studies was assessed using the Newcastle-Ottawa Scale, and the quality of cross-sectional studies was evaluated using AHRQ criteria. Two researchers independently screened the articles, extracted the data, and assessed the quality of the studies. A meta-analysis was conducted using Stata 15.0. Data not suitable for meta-analysis was analyzed through a qualitative synthesis to provide a comprehensive overview of the findings. RESULTS: A total of 12 studies were included, comprising nine cross-sectional studies and three longitudinal studies. All studies were of medium to high quality. Studies reported that pain was associated with 13 different types of BPSD, including agitation, aggression, abnormal thought process, anxiety, care refusal, delirium, depression, delusions, hallucinations, sexual disinhibition, sleep disturbances, socially inappropriate behavior, and wandering. A pooled odds ratio (OR) of 1.25 (95%CI [1.17,1.33], p < 0.001) indicated a significant positive association between pain and BPSD. Specifically, pain was positively associated with aggression (OR = 1.07, 95%CI [1.00,1.13], p = 0.035), agitation (OR = 1.17, 95%CI [1.14, 1.21], p < 0.001), and depression (OR = 2.11, 95%CI [1.76,2.52], p < 0.001). However, pain was significantly negatively associated with wandering (OR = 0.77, 95%CI [0.73, 0.81], p < 0.001). CONCLUSIONS: Pain was significantly positively associated with BPSD in patients with dementia, specifically with aggression, depression, and agitation. However, pain was negatively associated with wandering. This emphasizes the importance of further research in this area and improved interventions for pain and BPSD management. TRIAL REGISTRATION: www.crd.york.ac.uk CRD42023432320, registered 08/08/2024.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".