Table 3.
Association between cognitive impairment and pain behaviors among nursing home residents.
| Level of Cognitive Impairment | |||
|---|---|---|---|
| No/Mild (n= 224,239 ) | Moderate (n= 268,167) | Severe (n= 544,400 ) | |
| Vocal complaints | |||
| Percentage | 43.5 | 29.5 | 20.1 |
| Prevalence ratio (95% Confidence Interval): Crude |
1.00 | 0.68 (0.67 – 0.69) | 0.46 (0.45 – 0.47) |
| Adjusted* | 1.00 | 0.77 (0.76 – 0.78) | 0.56 (0.55 – 0.57) |
| Facial expressions | |||
| Percentage | 11.1 | 21.3 | 23.6 |
| Prevalence ratio (95% Confidence Interval): Crude |
1.00 | 1.92 (1.85 – 1.99) | 2.13 (2.05 – 2.22) |
| Adjusted* | 1.00 | 1.80 (1.74 – 1.86) | 1.90 (1.84 – 1.97) |
| Non-verbal sounds | |||
| Percentage | 5.6 | 12.6 | 15.4 |
| Prevalence ratio (95% Confidence Interval): Crude |
1.00 | 2.23 (2.15 – 2.32) | 2.73 (2.63 – 2.85) |
| Adjusted* | 1.00 | 1.99 (1.92 – 2.05) | 2.23 (2.16 – 2.32) |
| Protective body movements or postures | |||
| Percentage | 4.7 | 8.2 | 8.6 |
| Prevalence ratio (95% Confidence Interval): Crude |
1.00 | 1.76 (1.68 – 1.84) | 1.83 (1.75 – 1.92) |
| Adjusted* | 1.00 | 1.67 (1.60 – 1.74) | 1.72 (1.65 – 1.80) |
| Any pain behavior | |||
| Percentage | 48.1 | 42.4 | 38.4 |
| Prevalence ratio (95% Confidence Interval): Crude |
1.00 | 0.88 (0.87 – 0.90) | 0.80 (0.78 – 0.82) |
| Adjusted* | 1.00 | 0.94 (0.93 – 0.95) | 0.86 (0.85 – 0.88) |
*
Prevalence ratios adjusted for age, sex, rejection of care, hospice involvement, anxiety, dementia/Alzheimer’s disease, depression, limitations in activities of daily living, and painful conditions listed in Table 2.