Authors: Jiang, Xue et al.
Anesthesiology October 2025 | DOI: 10.1097/ALN.0000000000005731
This large longitudinal cohort study investigated whether chronic widespread pain (CWP) contributes to cognitive decline and dementia, as well as potential underlying mechanisms involving brain structure and systemic inflammation. Using data from nearly 190,000 UK Biobank participants followed over 13 years, researchers examined self-reported CWP, cognitive test performance, dementia incidence, and brain imaging biomarkers.
CWP was defined as pain throughout the body lasting three months or longer. Participants with CWP showed a significantly higher risk of developing mild cognitive impairment (HR 2.55, 95% CI 1.31–4.97) and dementia (HR 1.53, 95% CI 1.13–2.00). Although a direct causal link between CWP and dementia was not statistically confirmed (β = 1.50, PAdjusted = 0.076), evidence suggested that both structural brain changes and systemic inflammation might mediate this relationship.
Neuroimaging revealed that patients with CWP exhibited alterations in multiple brain regions related to sensory processing and emotional regulation—including the thalamus, insular cortex, prefrontal cortex, amygdala, and both pre- and postcentral gyri. Additionally, elevated systemic inflammatory markers such as lymphocytes, platelets, neutrophils, and leukocytes were observed, suggesting that chronic inflammation may contribute to neurodegeneration or impaired cognitive function.
The findings support the concept that chronic, diffuse pain syndromes can exert long-term effects on the brain through both inflammatory and structural pathways. This reinforces the importance of early recognition and management of chronic pain not only for symptom relief but also for potential neuroprotective benefit.
What You Should Know
Chronic widespread pain increases the risk of cognitive impairment and dementia, likely through combined effects of systemic inflammation and brain network remodeling. Addressing persistent pain early in life may help preserve cognitive health and reduce the burden of neurodegenerative disease.
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