Correlation between Biomarkers of Pain in Saliva and PAINAD Scale in Elderly People with Cognitive Impairment and Inability to Communicate

Abstract

The pain assessment in advanced dementia (PAINAD) appears to be a clinically useful tool. However, the salivary determination of tumor necrosis factor receptor type II (sTNF-RII) and secretory IgA (sIgA) as pain biomarkers is still incipient. The aim was to correlate the PAINAD score with sTNF-RII and sIgA biomarker levels in the saliva of patients with advanced dementia. In this regard, a cross-sectional study was conducted. The sample consisted of 75 elderly patients with a clinical diagnosis of dementia and a global deterioration scale (GDS) score of 5 to 7. The PAINAD scale was determined by a previously trained professional and the collection of salivary samples was performed using the passive secretion method. Human sTNF-RII and sIgA using ELISA kits. The results showed a correlation between the PAINAD scale (numeric, binary, and recoded) and sTNF-RII and sIgA (p < 0.001). No association between the sociodemographic and clinical variables and the PAINAD scale was found (p > 0.05). Between 97.3% and 96.2% of patients with pain on the PAINAD scale also showed pain based on the sTNF-RII levels; in all of them, sIgA levels did not fit the logistic models. Therefore, the correlation highlights the usefulness of this scale and confirms the usefulness of sTNF-RII and sIgA as biomarkers of pain.

Ordering Knowledge in the Markers of Psychiatric/Mental Disorders

“…Another study found higher d-serine levels in the serum and cerebrospinal fluid (CSF) of persons suffering from AD [41]. Antczak and colleagues [42] showed that transcranial magnetic stimulation (TMS) had some possibilities for improving the diagnostic accuracy and treatment of dementia, whereas the salivary immunological markers-sTNF-RII and sIgA-might be possible pain markers in dementia [43]. Another study showed that a dual-task test might be a helpful tool in differentiating patients with depression, MCI, and dementia [44].…”

Psychometric properties of pain measurements for people living with dementia: a COSMIN systematic review

“…Thirteen studies were performed in a hospital setting [ 16 , 18 – 29 ], 33 in care home facilities [ 17 , 30 – 61 ] and two studies were based in both care home and people’s home settings [ 62 , 63 ]. Two studies were performed both in care home and hospital settings [ 64 , 65 ]. The location of study was not stated in Lorenzet et al [ 66 ].…”

“…Twelve studies assessed the PAINAD [ 16 , 20 – 24 , 40 , 44 – 47 , 65 ]. Overall, the level of evidence for the PAINAD tool was limited (Table 3 ).…”

Non-Invasive Objective Markers to Measure Pain: A Direction to Develop a Pain Device - A Narrative Review

“…[ 13 ] Both soluble tumour necrosis factor-α receptor II (sTNF-RII) and sIgA can be a reliable salivary biomarkers for pain assessment but sTNF-RII can be more accurate in diagnosing pain in people with advanced dementia. [ 14 ] Alpha-amylase and IgA were present in higher amounts in the saliva of a patient with burning mouth syndrome [ 15 ] and these markers could be used as pain biomarkers. [ 16 ] The studies regarding pain assessment using salivary biomarkers are limited.…”