Authors: Jiang X. et al.
Anesthesiology, October 16, 2025. DOI: 10.1097/ALN.0000000000005731
This large longitudinal population-based study explored whether chronic widespread pain (CWP) contributes to the development of cognitive decline and dementia, using data from nearly 190,000 participants in the UK Biobank with a 13-year follow-up. CWP was defined as self-reported pain across multiple body regions lasting at least three months. Researchers evaluated cognitive outcomes through eight standardized tests and identified cases of mild cognitive impairment (MCI) and dementia using hospital records.
Participants with CWP were significantly more likely to develop cognitive impairment and dementia compared to pain-free controls. Specifically, CWP was linked to a 2.5-fold higher risk of MCI and a 1.5-fold increased risk of dementia. However, causality was not firmly established (β = 1.50, PAdjusted = 0.076). Imaging data revealed that alterations in several brain regions—particularly the thalamus, insula, prefrontal cortex, amygdala, and sensorimotor cortices—may mediate these associations. Systemic inflammation also appeared to play a contributing role, with elevated levels of lymphocytes, neutrophils, platelets, and leukocytes observed among those with CWP.
These findings indicate that chronic, diffuse pain is not merely a physical condition but one that may affect brain integrity and cognition through neuroinflammatory and neurodegenerative pathways. The authors emphasize that temporal limitations in biomarker collection necessitate cautious interpretation but underscore the need for early screening and interventions to mitigate cognitive risks in chronic pain populations.
What You Should Know
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Chronic widespread pain was associated with higher risks of both cognitive impairment and dementia over 13 years.
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Brain structure changes and systemic inflammation likely mediate these effects.
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No definitive causal link was proven, but the findings support a neuroinflammatory mechanism connecting chronic pain to cognitive decline.
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Early recognition of cognitive vulnerability in patients with CWP may improve long-term neurologic outcomes.
Thank you to Anesthesiology for publishing this important longitudinal study linking chronic widespread pain to dementia and cognitive impairment.