J Korean Med Sci.  2017 Nov;32(11):1852-1856. 10.3346/jkms.2017.32.11.1852.

Validity of the Korean Version of the Face, Legs, Activity, Cry, and Consolability Scale for Assessment of Pain in Dementia Patients

  • 1Department of Neurology, Konkuk University Medical Center, Seoul, Korea. alzdoc@kuh.ac.kr
  • 2Department of Quality Improvement, Konkuk University Medical Center, Seoul, Korea.
  • 3Department of Rehabilitation Medicines, Konkuk University Medical Center, Seoul, Korea.
  • 4Center for Geriatric Neuroscience Research, Institute of Biomedical Science, Konkuk University, Seoul, Korea.


Pain is often associated with a more rapid progression of cognitive and functional decline, and behavioral disturbance in dementia. Therefore, it is essential to accurately assesses pain for proper intervention in patients with dementia. The Face, Legs, Activity, Cry, and Consolability (FLACC) scale is an excellent behaviour scale which includes most of the domains that are recommended by the American Geriatrics Society to evaluate when assessing pain in patients with dementia. The purpose of this study was to develop the Korean version of the FLACC (K-FLACC) and to verify its reliability and validity in assessing pain of elderly patients with dementia. We developed the K-FLACC to consist of the five domains (face, legs, activity, cry, and consolability) with scores of 0, 1, and 2 for each domain and a total score ranging from 0 to 10 as in the original FLACC. Eighty-eight patients with dementia who visited Konkuk University Medical Center were evaluated. The K-FLACC revealed good validity as compared to the Numeric Rating Scale (NRS; r = 0.617, P < 0.001) and the Face Pain Scale (FPS; r = 0.350, P = 0.001). All of the five domains of the K-FLACC were related to the NRS and FPS, in which the activity domain showed the highest correlation. Test-retest reliability was excellent, as the intra-class correlation coefficient comparing the retest to test was 0.73 (95% confidence interval, 0.59-0.82). Our results show that the K-FLACC is a suitable and valuable scale to assess pain in patients with dementia in Korea.


Pain; Dementia; Screening; Scale

MeSH Terms

Academic Medical Centers
Facial Pain
Mass Screening
Reproducibility of Results


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