Pain as an underrecognized geriatric syndrome in hospitalized older adults with major neurocognitive disorder: clinical correlates and outcomes

Aim: To examine pain as a geriatric syndrome in hospitalized older adults with cognitive impairment and assess its prevalence, clinical correlates, and impact on frailty, quality of life, and short-term mortality. Findings: Higher PAIN-AD scores correlated with greater frailty, poorer quality of life, and higher short-term mortality. PAIN-AD remained independently associated with frailty, reduced quality of life, and mortality in adjusted models. Survival was significantly lower in individuals with higher PAIN-AD scores. Message: Pain in dementia is frequently overlooked and minimally treated, yet strongly linked to vulnerability and adverse outcomes. Routine use of PAIN-AD may improve detection and management in geriatric care.