TITLE:
Pain Assessment Tools for People with Dementia: A Literature Review
AUTHORS:
Maryam Amjad Baig
KEYWORDS:
Dementia, Pain Assessment, Pain Measurement, Psychometrics, PainChek
JOURNAL NAME:
Advances in Alzheimer's Disease,
Vol.15 No.1,
March
31,
2026
ABSTRACT: Background: Dementia, ranked as the 7th leading global cause of death, poses challenges for pain assessment due to cognitive and communication impairments. Recent research addresses this gap by examining pain assessment tools for moderate to severe dementia. This review analyses the psychometric properties and clinical utility of these tools, including a comparison with the novel ePAT tool and its potential impact on health. Method: The study used the PRISMA checklist to analyse literature from 2003 to 2023. Online searches with specific keywords and free-text terms were conducted. Titles, abstracts, and full texts of potential studies were evaluated for inclusion, along with relevant bibliographic lists. Selected studies underwent appraisal and analysis. Results: 34 pain assessment tools used for elderly individuals with moderate to severe dementia were found, with PAINAD, CNPI, DOLOPLUS-2, APS, PACSLAC, NOPPAIN, PADE, MOBID, DS-DAT, CPAT, and ePAT being the most frequent. While most tools showed moderate to good validity, reliability, and internal consistency, ePAT showed strong results and a positive health service impact. Conclusions: Based on the evidence reviewed, no definite gold standard tool was detected. Although ePAT shows positive outcomes, its testing has mainly been done in Residential Aged Care Facilities. Further validation and testing across various healthcare settings are needed.