Question: In adults with progressed dementia, how effective is analgesia, compared with any other pharmacological intervention, in decreasing behavioural and psychological symptoms, specifically aggression and agitation?

Answer:

Plain language summary

No studies could be identified that compared pain relief medication (Analgesia) to any other medication to measure how effective it was in reducing aggression/agitation in people with dementia. One study comparing pain relief to any other treatment provided limited evidence suggesting that pain relief may be linked to reduced agitation. Further research need to be conducted on this topic

Clinical and research implications

Limited evidence, from one randomised controlled trial, indicates that the use of a pain treatment protocol may be associated with reduced agitation (particularly verbal agitation behaviours) compared to treatment as usual, when used in very elderly patients with moderate to severe dementia. Two small crossover trials, included in two systematic reviews, did not provide significant additional evidence. No studies were identified which compared the effectiveness of analgesia to that of other active pharmacological interventions for behavioural disturbance.

Further studies are needed to fully evaluate the potential effects of pain management on behavioural disturbance in people with dementia.

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