Name of Fellow


Elisabeth Flo

Institution


Funder


RCN

Contact information of fellow


Country


Norway

Title of project/programme


Efficacy of Pain Treatment on Depression in Patients with Dementia. A Randomized Clinical Trial of Efficacy

Source of funding information


RCN

Total sum awarded (Euro)


€ 312,175

Start date of award


01/08/13

Total duration of award in years


3.0

The project/programme is most relevant to:


Alzheimer's disease & other dementias

Keywords


pain treatment | depression | dementia

Research Abstract


Depression is common in older people and nursing home (NH) patients with dementia. Treatment with antidepressants is a clinical priority but the evidence base is sparse and studies demonstrate absence of benefit compared to placebo and increased risk of s everal adverse events in intervention groups. Depression is a common co-morbidity amongst people with chronic pain in form of interactive relationship. Our own research demonstrated efficacy of pain treatment on agitation and aggression in patients with d ementia. Secondary analyses suggest benefit of pain treatment also on depression. It is crucial to follow up these results: DEP.PAIN.DEM (Depression and Pain in Patients with Dementia) a 13 weeks, multicenter, parallel-group, double-blind RCT, aims to inv estigate the efficacy of pain treatment on depression in patients with dementia. Participant (N=266) will be included from 3 old-age psychiatry clinics and from 12 NHs (Bergen, Stavanger, Haugesund). Patients are eligible if they are >59 years, with proba ble or possible dementia (in accordance to NINCDS, ADRDA), coexisting depression (>3 weeks duration) that was assessed as needing antidepressants (CSDD>7), or despite ongoing treatment with antidepressant. Exclusion criteria: Advanced severe medical disea se with expected survival <6 months, severe psychiatric disorder, and severe aggression. Patients will be randomized (1:1) to pain treatment with paracetamol or buprenorphine for 13 weeks, or placebo. Primary and secondary outcomes will be assessed at bas eline, week 2, 4, 8, and 13 using: Cornell; NPI-NH; MOBID-2 Pain Scale; DEMQOL; UKU; MMSE; ADL, and adverse events. Statistics: Chi square-, Mann-Whitney U analyses between groups, ANCOVA, LOCF, ICC, p-values. Collaboration is established between UiB, Sta vanger Univ. Hospital; Karolinska, Stockholm; Kings College, London; and EU-COST-ActionTD1005. We apply for a 4-year project leader (50%) and a PhD-candidate (100%). A comprehensive dissemination plan is availa

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