• Paul A Beach, Angela Humbel, Mary S Dietrich, Stephen Bruehl, Ronald L Cowan, Karen O Moss, and Todd B Monroe.
• Department of Neurology, Emory University School of Medicine, Atlanta, Georgia.
• Pain Med. 2022 Jul 1; 23 (7): 1231-1238.

ObjectiveAdvanced age is associated with a higher risk of both pain and dementia, with many studies finding that dementia often heightens sensitivity to pain. Vascular dementia (VaD) is the second most common type of dementia. Only a few observational or retrospective studies have examined pain responsiveness in VaD, suggesting that it could increase pain unpleasantness (i.e., pain affect). This study compared thermal pain psychophysics between a cohort of patients with VaD and healthy control (HC) subjects.DesignSingle-center, cross-sectional, between-subjects design.SubjectsVerbally communicative patients with probable VaD (n = 23) and age- and sex-matched HCs (n = 23).MethodsA thermal psychophysics protocol assessed "mild pain" and "moderate pain" thresholds (temperature in degrees Celsius) and associated unpleasantness ratings (0-20 scale) in both the VaD and HC groups. Psychophysics were compared between groups by way of a mixed-effects analysis, controlling for depressive symptoms.ResultsThere were no significant differences between groups for pain thresholds (main effect P = 0.086, Cohen's d: mild = 0.55, moderate = 0.27). However, unpleasantness ratings were higher in the VaD group than in the HC group (main effect P = 0.003; mild pain P = 0.022, Cohen's d = 0.79; moderate pain P = 0.057, Cohen's d = 0.6).ConclusionsThese results are consistent with prior observational findings suggesting that VaD could make patients more susceptible to pain, particularly its affective component.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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