Does Persistent Pain Increase the Risk of Cognitive Decline?

Persistent pain was associated with increased memory decline and risk of dementia in older adults, according to the findings of a recent study.

The cohort study included 10,065 community-dwelling older adults from the Health and Retirement Study who answered questions on pain and cognition in 1998 and 2000 (60% were female, median baseline age was 73 years). Primary outcomes assessed in the study included composite memory score and dementia probability, and linear mixed-effects models were used to estimate the association between persistent pain with cognitive trajectory.
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Of the 10,065 participants, 10.9% were affected by persistent pain at baseline. Persistent pain was associated with worse depressive symptoms and more limitations in activities associated with daily living.

Participants with persistent pain had a 9.2% more rapid decline in memory when compared to participants without persistent pain in covariate adjustments. This accelerated decline implied a higher risk in reduced functional independence after 10 years, corresponding to a 15.9% higher relative risk in the inability to manage medications and a 11.8% higher relative risk in the inability to manage finances independently.

In addition, participants with persistent pain had a 7.7% faster adjusted dementia probability, which correlated to an absolute 2.2% increase in dementia probability with persistent pain after 10 years.

“Persistent pain was associated with accelerated memory decline and increased probability of dementia,” the researchers concluded. “[This] may help identify elders at risk of accelerated cognitive decline.”

—Melissa Weiss

Reference:

Whitlock EL, Diaz-Ramirez G, Glymour M, et al. Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders [published online June 5, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.1622