Over the years, there have been many reports on the under-treatment of pain in vulnerable older people, especially in persons with dementia. Starting with the study of Ferrell et al. [1] in 1995, again and again lower rates of pharmacological pain treatment have been found for older people and especially for people with cognitive impairment. This holds for studies in the community, in residential settings and nursing homes, and even in post-operative hospital patients [2–5]. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library