Data have shown that people with dementia are six times more likely to be admitted to the hospital with delirium. Further, delirium is associated with an increased risk of death or further hospitalization within the next 12 months. This study assessed the relationship between pain and delirium in patients with dementia in an acute hospital setting.

All hospitalized patients with a pre -existing, documented dementia were eligible to participate. Patients were screened at hospital admission with the Confusion Assessment Method (CAM). Those without delirium completed a Mini-Mental State Exam (MMSE). Data were gathered every four days, including assessments of dementia, self-reported and observational estimates of pain.

Of the 230 participants, 10% experienced pain at rest and 42% experienced pain during activity. The odds of delirium were 3.26 times higher among those with pain at rest (P=0.044), with no increased risk among those with pain during activity. Over half of those with delirium who were unable to report pain were judged to be in pain during activity. No significant difference was seen in the occurrence of delirium between those who were prescribed analgesics and those who were not.

This study of patients with dementia found that, during hospitalization, the odds of delirium were over three times higher among those experiencing pain at rest.