ABSTRACT
The question of pain prevention is becoming increasingly important, both in society and in science. According to the International Society for the Study of Pain, general areas for which pain prevention measures can be recommended have been defined. These approaches are mostly limited to unspecific recommendations with the aim of improving general health behaviour. Common to all of them is that they essentially address psychosocial and psychobehavioral aspects. In contrast to genetic factors or other non-modifiable environmental factors, psychosocial and psychobehavioral aspects are potentially modifiable variables, making them possible starting points for prevention programs. Furthermore, recent studies provide important knowledge about psychological and social risk factors of pain chronification and thus offer new approaches for future pain prevention strategies. At the same time, the efficacy and successful implementation of such programs is so complex that valid statements on effectiveness and benefit can only be made through care-related evaluation. This review addresses psychological and social factors in the prevention of pain. A selective literature search was carried out to this end. Based on selected studies, psychological and social predictors of pain development are presented and their potential for future pain prevention programs discussed. The article concludes with a discussion of possible implications.
Subject(s)
Pain , Humans , Pain/prevention & control , Pain/psychology , Social BehaviorABSTRACT
BACKGROUND/AIMS: Mild cognitive impairment (MCI) is a frequent syndrome in the older population, which involves an increased risk to develop Alzheimer's disease (AD). The latter can be modified by the cognitive reserve, which can be operationalized by the length of school education. MCI can be differentiated into four subtypes according to the cognitive domains involved: amnestic MCI, multiple-domain amnestic MCI, non-amnestic MCI and multiple-domain non-amnestic MCI. While neurocognitive deficits are a constituent of the diagnosis of these subtypes, the question of how they refer to the cognitive reserve still needs to be clarified. METHODS: We examined neuropsychological deficits in healthy controls, patients with MCI and patients with mild AD (n = 485) derived from a memory clinic. To reduce the number of neuropsychological variables, a factor analysis with varimax rotation was calculated. In a second step, diagnostic groups including MCI subtypes were compared with respect to their clinical and neuropsychological characteristics including cognitive reserve. RESULTS: Most MCI patients showed the amnestic multiple-domain subtype followed by the pure amnestic subtype, while the non-amnestic subtypes were rare. The amnestic subtype displayed a significantly higher level of cognitive reserve and higher MMSE scores than the amnestic multiple-domain subtype, which was in most cases characterized by additional psychomotor and executive deficits. CONCLUSIONS: These findings confirm earlier reports revealing that the amnestic multiple-domain subtype is the most frequent one and indicating that a high cognitive reserve may primarily prevent psychomotor and executive deficits in MCI.
