COSMIN database

Pain assessment tools for older adults with dementia in long-term care facilities: a systematic review

Chow, S., Chow, R., Lam, M., Rowbottom, L., Hollenberg, D., Friesen, E., Nadalini, O., Lam, H., DeAngelis, C., and Herrmann, N.
AIM: The aim of this review is to document pain assessment tools used primarily for older adults in long-term care facilities and compare self-report and observer-rated tools.

METHODS: A literature search was conducted in Ovid MEDLINE((R)), Embase, Cochrane and PsycINFO. Keywords included 'dementia', 'pain management' and 'managing pain'.

RESULTS: Of 1033 references, 23 articles were selected for inclusion. Six tools were self-rated and 18 tools were administered by an observer. 13 studies evaluated the reliability/validity of their scales; four studies compared different scales against each other.

CONCLUSION: Self-report should be the first-line approach when possible, with observational assessment used as a supplementary tool. Reliable observational tools have been shortened, and shown to maintain high reliability/validity, and positive psychometric properties.
Neurodegener Dis Manag
Publication year:
Symptom status:
Physical state
Seniors (65+)
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
7 - Observations
APS - Abbey Pain Scale
CNPI - Checklist for Nonverbal Pain Indicators
C-PAINAD - Chinese-Pain Assessment in Advanced Dementia
CPAT - Certified Nursing Assistant Pain Assessment Tool
FPS - Functional Pain Scale
FPS-R - Faces Pain Scale-Revised   
GPA - Global Pain Assessment
MDS-PBS - Minimum Data Set – Pain Behavior Scale
MOBID-2 - Mobilization–Observation–Behaviour–Intensity–Dementia-2
MPS - Mahoney Pain Scale
NOPPAIN - Non-Communicative Patient’s Pain Assessment Instrument
OPBAI: - Observational Pain Behavior Assessment Instrument
PACI - Pain Assessment in the Communicatively Impaired
PACSLAC-D - Pain Assessment Checklist for Seniors with Limited Ability to Communicate – Dutch   
PACSLAC-II - Pain Assessment Checklist for Seniors with Limited Ability to Communicate – II
PACSLAC - pain assessment checklist for seniors with limited ability to communicate   
PADE - Pain Assessment for the Dementing Elderly
PAINAD - Pain Assessment in Advanced Dementia Scale
PAINE - Pain Assessment in Non-communicative Elderly
PPI - Present Pain Intensity
RAI - Resident Assessment Instrument (ALSO RAI-PC - Resident Assessment Instrument for Palliative Care)
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
VDS - Verbal Descriptor Scale