Objective: The aim of this study was the assess the prevalence of pain in Parkinson’s disease dementia, its clinical characteristics, and correlations with motor part and degree of dementia.

Background: The pain in Parkinson’s disease dementia (PDD) is an under recognized and under treated non motor symptom. Assessment of pain in advanced PDD is a challenge due to the reduced capacity of self-reporting.

Method: Prospective study on 31 PDD patients. We used a standardized questionnaire, Pain Assessment in advanced dementia (PAINAD) Scale, Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-II), Functional Assessment Staging (FAST).

Results: There were 11 mild, 8 moderate and 12 severe dementia cases. In the advanced dementia patients we were focusing especially on the facial expressions, verbalizations, body movements, interpersonal interactions, mental status changes.
The overall prevalence of pain was 26/31 (83,97%). According to the subgroups, pain was present in 8/11 in the mild, 7/8 in the moderate and respectively 11/12 in advanced cases. The most frequent type of pain was musculoskeletal, followed by genital organs pain (especially in patients with genitourinary infection). Severity of pain correlated with dementia severity and motor disability. Pain was associated with agitation and hallucinations. People with more pain had significant more disrupted sleep. From the total of 26 PDD patients with pain, 12 did not disclosed it to the neurologists.

Conclusion: Pain has a high prevalence in PDD patients. In severe cases there is need to actively screen the pain using non-verbal assessment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-characteristics-of-pain-in-parkinsons-disease-dementia/