Recognizing Pain Intensity in Alzheimer's Disease

Summary

The most common form of dementia is Alzheimer's disease, with 900,000 people affected in France in 2015 and a forecast of 1.3 million in 2020. As a consequence of their advanced age, dementia patients often suffer from pain, mainly musculoskeletal or neuropathic pain. However, the exact prevalence of pain in dementia is underestimated. Indeed, several studies indicate that people suffering from dementia report less pain. This phenomenon is all the more true as the stage of dementia is advanced. In addition, people with dementia receive less pain medication than people without cognitive impairment in similarly painful conditions. Hetero-evaluation alone also seems insufficient, with the result that pain is under-treated compared to patients without cognitive impairment. Better pain screening is a major challenge and self-assessment tools should be favoured as a first line of treatment, even for patients with cognitive impairment. suffering from dementia.

The investigators propose in this work to evaluate the variation of vegetative parameters that accompany a painful stimulus. These variations can be recorded at the cardiac, vascular, pupillary or skin conductance level.

Conditions

• Alzheimer Disease
• Pain
• Autonomic Nervous System Disease

Interventions

DIAGNOSTIC_TEST

cognitive assessment

global cognitive assessment : * Mini Mental State * Evaluation of manual laterality * Hospital Anxiety and Depression scale * 5 words of Dubois * Trail Making Test * short battery of the praxies * neuropathic pain scale (DN4 in french) * Analog Visual Scale for pain * Fast Front End Efficiency Battery

OTHER

Cold Pressor Test

consists of the complete immersion of the participant's arm in a basin of cold water maintained at a temperature. The test will be divided into two conditions (pain, no pain). In the first, the container will be filled with cold water. In the second, the water in the container will be at room temperature. The investigators will test each arm. During the immersion of the arm, participants will have to remain silent and remove their arm when the ordeal becomes too painful for the painful condition. For the non-painful condition, the immersion time will be determined according to the results of the pre test.

OTHER

digital sensor of Nociception Level Index

placed on the contralateral index finger with the arm immersed in the tank to measure the variation of physiological parameters.

Sponsors & Collaborators

• Centre Hospitalier Universitaire de Saint Etienne

  lead OTHER

Principal Investigators

• Céline BORG, MD · CHU of Saint Etienne

Study Design

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

60 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-11-24

Primary Completion

2023-04-06

Completion

2023-04-06

Countries

• France

Study Locations