|Authors: Whitlock EL et al., JAMA Intern Med 2017 Jun 5;
Persistent moderate-to-severe pain was associated with about a 2% increase in absolute risk for developing dementia.
|One quarter to one third of older adults have chronic pain, and cross-sectional studies have shown associations between chronic pain and cognitive decline. In this study, researchers used data from a national health and retirement study to explore the longitudinal relation between chronic pain and subsequent cognitive decline in about 10,000 older adults (median age, 73; mostly white women). Participants were assessed every 2 years for pain and cognitive function, and those who reported moderate-to-severe pain at baseline and at 2 years — about 11% of participants — were considered to have persistent pain; those with less or no pain served as the control group. Baseline prevalence of arthritis and depression was higher in the persistent-pain group than in controls (91% vs. 60%).
At median follow-up of about 10 years, cognitive decline was greater in the persistent-pain group than in controls. In analyses adjusted for a wide range of demographic and clinical factors (but not for medications such as opioids or psychotropic drugs), risk for developing dementia was significantly higher in persistent-pain patients than in controls (about 22% vs. 20%). Risk for having difficulty managing medications or finances was also about 2 percentage points higher in persistent-pain patients.