Background: Among cognitively intact patients, self- and caregiver report of patient pain has
been associated with worse psychological health for both the patient and caregiver. Little existing
research examines factors associated with patient self-report of pain and caregiver report
of patient pain among community-dwelling persons with dementia.
Objective: To identify patient and caregiver factors associated with self- and caregiver report
of patient pain among community-dwelling persons with dementia.
Design: Cross-sectional analysis of a longitudinal study using structured interviews with
dementia patients and their family caregivers.
Setting and subjects: Urban outpatient geriatrics clinics affiliated with a university hospital.
Dyads composed of dementia patients and their family caregivers were approached prior
to routine clinic visits to participate in the study.
Measurements: Relevant patient measurements included self-report of pain; cognitive, functional,
and comorbidity assessments; a screen for depression; and demographic information.
Relevant caregiver measurements included their report of patient pain and agitation, screens
for depression and strain, and demographic information.
Results: Of 115 dyads, 37 patients (32%) and 57 caregivers (53%) reported the patient to be
in pain. No patient or caregiver factors were significantly associated with patient self-report
of pain. In the univariate analysis, caregiver reports of patient pain were associated with the
patient not being depressed (p = .036), caregiver reports of patient agitation (p = .038), higher
level of education in the caregiver (p = .029), and caregiver depression (p = .019). In multivariate
logistic regression analyses, caregiver depression and patient agitation remained significantly
associated with caregiver report of patient pain.
Conclusions: In community-dwelling persons with dementia, self-report of pain was not associated
with any other variables measured, suggesting that pain should be assessed through
direct self-report and treated accordingly. Caregiver report of patient pain was associated with
both caregiver report of patient agitation and caregiver depression. These findings suggest
that clinicians may need to routinely assess patient pain, patient agitation, and caregiver depression.
More research is needed to understand the relationship between these conditions.
