• Joukje M Oosterman, Hedwig Hendriks, Sharon Scott, Kathryn Lord, Nicola White, and Elizabeth L Sampson.
• Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
• Pain Med. 2014 May 1; 15 (5): 751-7.

ObjectiveIt has been documented that pain in people with dementia is often under-reported and poorly detected. The reasons for this are not clearly defined. This project aimed to explore semantic concepts of pain in people with dementia and whether this is associated with clinical pain report.DesignCohort study with nested cross-sectional analysis.SettingAcute general hospital medical wards for older people.SubjectsPeople with dementia (N = 26) and control participants (N = 13).MethodsTwo subtests of semantic memory for pain: (1) Identifying painful situations from a standardized range of pictures; (2) Describing the concept of pain. Participants also indicated whether they were in pain or not, were observed for pain (PAINAD scale) and completed the Wong-Baker FACES scale to indicate pain severity.ResultsCompared with the control group, people with dementia were less able to identify painful situations and used fewer categories to define their concept of pain. In turn, the performance on these two measures was related to the reported presence and, albeit less strongly, to the reported severity of pain, indicating that a reduction in semantic memory for pain is associated with a decline in reported pain.ConclusionsThis study is the first to show that semantic memory for pain is diminished in dementia patients. When using clinical pain tools, clinicians should consider these effects which may bias clinical pain ratings when they evaluate and manage pain in these patients. This might improve the recognition and management of pain in people with dementia.Wiley Periodicals, Inc.

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