Keele Research Repository

Painful musculoskeletal conditions are common in older adults, however pain identification, assessment, and management are reported to be suboptimal for people with dementia. Adequate pain management is an integral aspect of care for people with dementia to prevent or delay negative outcomes, such as behavioural and psychological changes, emergency department attendance, and premature nursing home admission. This study aims to examine musculoskeletal consultations and analgesic prescriptions for people with dementia compared to people without dementia. A dementia cohort (n=36,582) and matched cohort were identified in the Clinical Practice Research Datalink (a UK wide primary care database). Period prevalence for musculoskeletal consultations and analgesic prescriptions were described and logistic regression applied to estimate associations between dementia and musculoskeletal consultation/analgesic prescription from time of dementia diagnosis to 5 years post diagnosis. People with dementia had a consistently (over time) lower prevalence and odds of musculoskeletal consultation and analgesic prescription compared to people without dementia. The evidence suggests that pain management may be suboptimal for people with dementia. These results highlight the need to understand more about practical methods to increase awareness of pain and to employ better methods of pain assessment, evaluation of treatment response and acceptable and effective management for people with dementia, in primary care.