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Centre for Elderly and Nursing Home Medicine (SEFAS)

The DEP.PAIN.DEM study

Does treating pain have a positive effect on depression in nursing home patients with dementia?

Sykehjemsmedisin

Depression is one of the most common neuropsychiatric symptoms in dementia. We know that many patients with dementia have difficulty communicating pain. When pain and depression co-occur, the conditions may exacerbate each other and make it more difficult to treat symptoms successfully.

Almost half of nursing home patients in Norway use antidepressants, often without sufficient assessment of treatment effect and adverse effects. Recent studies suggest that antidepressants may be less effective in patients with dementia compared to cognitively intact patients. Additionally, we know that antidepressants often have adverse effects in elderly patients, such as nausea, reduced appetite, drowsiness, low blood pressure, and increased risk of falls and mortality.

Because previous studies have shown that undiagnosed and undertreated pain may increase the risk of depression, we want to examine whether an increase in pain treatment may have a positive effect on symptoms of depression in people with dementia.

Method

DEP.PAIN.DEM is a multicentre, randomised, placebo controlled trial which aims to determine whether an individualised increase in analgesic treatment over 13 weeks effectively reduces symptoms of depression in nursing home patients with dementia and depression.

The research team has included 165 patients from 47 nursing homes in different regions of Norway (Hordaland, Møre og Romsdal, Rogaland, Oslo, Akershus and Østfold). Data collection was completed in December 2016.