COSMIN database

Tools for assessment of pain in nonverbal older adults with dementia: a state-of-the-science review

Herr, K., Bjoro, K., and Decker, S.
To improve assessment and management of pain in nonverbal older adults with dementia, an effective means of recognizing and evaluating pain in this vulnerable population is needed. The purpose of this review is to critically evaluate the existing tools used for pain assessment in this population to provide recommendations to clinicians. Ten pain assessment tools based on observation of behavioral indicators for use with nonverbal older adults with dementia were evaluated according to criteria and indicators in five areas: conceptualization, subjects, administration, reliability, and validity. Results indicate that although a number of tools demonstrate potential, existing tools are still in the early stages of development and testing. Currently, there is no standardized tool based on nonverbal behavioral pain indicators in English that may be recommended for broad adoption in clinical practice.
J Pain Symptom Manage
0885-3924 (Print)
Publication year:
Symptom status:
Physical state
Seniors (65+)
Diseases of and symptoms related to the nervous system
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
5 - Videos
6 - Clinical rating scales
7 - Observations
ADD - Assessment for Discomfort in Dementia
APS - Abbey Pain Scale
CNPI - Checklist for Nonverbal Pain Indicators
Doloplus-II   Logozuyd
DS-DAT - Discomfort Scale –Dementia of Alzheimer Type
FLACC - Faces, Legs, Activity, Cry and Consolability Scale
NOPPAIN - Non-Communicative Patient’s Pain Assessment Instrument
PACSLAC - pain assessment checklist for seniors with limited ability to communicate   Logozuyd
PADE - Pain Assessment for the Dementing Elderly
PAINAD - Pain Assessment in Advanced Dementia Scale