We thank Pu and colleagues for their published study evaluating the effectiveness
of PARO on sleep and motor activity in people living with dementia (PLWD) and chronic
pain [
[1]
]. Such studies generate evidence on novel non-pharmacological/psychosocial interventions
for behaviours and psychological symptoms of dementia (BPSD) - a significant area
of research for optimising the quality of dementia care. While we commend the authors’
efforts in conducting this research, the findings of the study should be interpreted
with caution for the following reasons:
- 1)Given that a large proportion of PLWD are commonly prescribed psychotropic medications (e.g., antipsychotics, antidepressants, anti-dementia drugs and opioids) [[2],[3]], which are known to cause (over-)sedation, how did the authors account for this confounding effect on sleep outcomes? That is, how we would know that the results were not falsely attributed to PARO rather than the prescribed concurrent medications, and hence were independent of this covariate?
- 2)The Mini-Mental State Examination (MMSE) scores were <11 for 45.0 % and 71.4 % for control and intervention groups, respectively. This indicates that most of the sample had severe dementia [[4]], which is characterised by a diminished capacity to report or rate pain. As noted by the authors (Table 1), the range of MMSE scores was 0–24, suggesting that some participants may have had the ability to verbalise pain [[5]], which is deemed the gold standard of pain assessment. However, the authors completed proxy pain assessments for the total sample.
- 3)No validated (proxy) pain assessment tools were used in the study; yet pain intensity scores and categories were reported for both groups.
- 4)Chronic pain (conditions) was (were) not operationally defined (or described) in the sample.
Abbreviations:
PLWD (people living with dementia), BPSD (behaviours and psychological symptoms of dementia), MMSE (Mini-Mental State Examination)To read this article in full you will need to make a payment
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References
- The effect of a social robot intervention on sleep and motor activity of people living with dementia and chronic pain: a pilot randomized controlled trial.Maturitas. 2021; 144: 16-22
- The dispensing of psychotropic medicines to older people before and after they enter residential aged care.Med J Australia. 2020; 212: 309-313
- Analgesic use and pain in residents with and without dementia in aged care facilities: A cross-sectional study.Australas. J. Ageing. 2016; 35: 180-187
- Mapping scores onto stages: mini-mental state examination and clinical dementia rating.Am. J. Geriatr. Psychiatry. 2006; 14: 139-144
- Pain in severe dementia: self-assessment or observational scales?.J. Am. Geriatr. Soc. 2006; 54: 1040-1045
Article info
Publication history
Published online: January 06, 2021
Accepted:
December 23,
2020
Received:
November 4,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Authors’ response to Atee et alMaturitasVol. 145
