People with dementia often react more strongly to pain than others. This happens because their brains process pain differently due to the disease.
Dementia, like Alzheimer’s disease, damages key brain areas. The hippocampus, an early target in Alzheimer’s, handles both memory and pain signals. When it breaks down, pain feels sharper and lasts longer.[1] Brain regions for pain overlap with those hit by dementia, messing up how pain travels through the body.
Microglia, the brain’s immune cells, play a big role too. In dementia, sticky plaques and tangled proteins wake these cells up. They cause swelling and change how nerves work, making pain sensitivity skyrocket.[1] Nerve injuries from conditions like diabetes can trigger the same microglia response, linking chronic pain and dementia in a two-way street.[1]
Pain demands a lot of brain power. In dementia, this pulls resources from thinking and memory, worsening confusion and distress.[3] Patients might not explain their pain well, so reactions come out as agitation, crying, or lashing out. These strong responses signal hidden discomfort that needs attention.
Sources
https://pmc.ncbi.nlm.nih.gov/articles/PMC12691660/
https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2025.1694007/full
https://pmc.ncbi.nlm.nih.gov/articles/PMC12705290/
