Pain relief as a treatment for agitation and aggression in persons with dementia.

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Behavioural and psychological symptoms of dementia (BPSD), particularly agitation and aggressive behaviours, are a major cause of distress and are often difficult to manage. Treatment of BPSD is currently focused on suppression of symptoms rather than addressing the triggering factors. Unrelieved pain is very common in older persons in residential aged care facilities and is considered to be a particularly important target within the context of ameliorating BPSD. There have been relatively few studies to examine systematically the relationship between pain and agitation/aggression, as well as other specific types of BPSD, and the evidence for a causal association between these very common conditions is currently lacking. The overall aim of the present study is to undertake a randomised controlled trial of analgesic interventions to specifically monitor changes in pain and consequent changes in the frequency of agitation/aggression and other BPSD in persons with dementia. By completion, we will have important new insights into the strength of causal relationship between pain, aggression/agitation and other types of BPSD (ie. depression), and the first ever evidence on the use of analgesics to relieve pain in older cognitively impaired adults and thereby reduce the frequency of various BPSD. The improved evidence base will help guide future clinical management of agitation/aggression and other BPSD and ultimately contribute to an improved quality of life for persons with dementia and a reduced burden of care and carer stress.

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