Wednesday, November 23, 2005
The over-the-counter painkiller acetaminophen may help elderly adults with dementia become more active and socially engaged, the results of a small study suggest.
Researchers found that when they gave acetaminophen to nursing home patients who had moderate to severe dementia, the medication helped changed some of the patients' behaviors. They tended, for example, to spend less time in their rooms and more time watching television, listening to music, reading or performing "work-like" activities.
The findings suggest that unrecognized, untreated pain in dementia patients keeps them from being as active as they can be, according to the study authors, led by Dr. John T. Chibnall of the Saint Louis University School of Medicine in Missouri.
"Pain treatment in this group may facilitate engagement with the environment," they report in the Journal of the American Geriatrics Society.
Chronic pain is a common problem for elderly adults, stemming from conditions such as arthritis, bone fractures and nerve damage from diabetes. But Alzheimer's disease and other forms of dementia can get in the way of diagnosing and treating chronic pain. Patients may, for instance, be unable to express what they are feeling.
What's more, untreated pain may exacerbate problems associated with dementia, such as inactivity, agitation and depression.
To see if a mild painkiller could change dementia patients' behavior, Chibnall and his colleagues studied the effects of 4 weeks of treatment with acetaminophen (Tylenol). Twenty-five nursing home residents with moderate to severe dementia spent 4 weeks taking three daily doses of acetaminophen and another 4 weeks taking inactive pills.
Overall, the study found that patients spent less time by themselves and more time being socially active when using acetaminophen. They also spent more time talking to themselves or an "imaginary other," which, according to the researchers, is also a manifestation of heightened engagement.
On the other hand, although certain behaviors showed positive changes, agitation and emotional well-being did not improve.
Still, Chibnall and his colleagues conclude, the findings suggest that treating pain with mild medications can help improve dementia patients' social interactions.
"With further research and more aggressive treatment of pain," they write, "nursing home residents with dementia may be helped to lead more interactive lives."
McNeil Consumer & Specialty Pharmaceuticals, maker of Tylenol, supplied the medication used in the study.