What is pain in dementia?

Yes. People with dementia feel pain, but they may lose the ability to describe it. A 2024 review in PMC notes that health professionals once believed older adults did not feel pain the same way, a misconception made worse when dementia makes pain hard to communicate. Its authors stress that if a person is showing signs of pain, they most probably have pain.

Watch for changes in behavior. A 2024 review in PMC lists facial grimacing, moaning, guarding a part of the body, restlessness, agitation and wandering as possible signs. Some people go quiet when in pain while others become agitated, so the people who know the person's usual behavior are often the first to notice. Any sudden change is worth raising with a doctor.

It depends on the stage. A 2024 review in PMC says simple self-report tools, such as numerical rating scales or a faces pain scale, can still work in mild to moderate dementia. For moderate to severe dementia, observation tools such as PAINAD, Doloplus 2 and the Abbey scale score behaviors like facial expression and restlessness. Family input helps.

Pain can make dementia symptoms worse, especially behavior. The National Institute on Aging lists pain among the common causes of agitation and aggression in people with Alzheimer's, and suggests looking for the cause and asking a health care provider about solutions. A medical exam can find physical problems behind new behavior. If symptoms change suddenly, contact the doctor promptly.

Mainly because people with dementia find it hard to say they hurt. A 2024 review in PMC adds that many older adults see pain as a normal part of aging and do not like to complain. It cites studies in which a hip fracture patient with dementia received one third the morphine dose of one without dementia, and fewer received standard pain relief after surgery.