Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders

Primary tabs

SCIENCE
Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders
Key Take-Away: 

It has been determined in this study that persistent pain is associated with numerous health hazards such as depression, anxiety, avoidance of activity and sleep impairment. Persistent pain significantly affects memory decline and increases the probability of dementia after timer period of ten years.

Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown.

ABSTRACT: 
Background: 

Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown.

The objective of this study was to determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline. 

Methods: 

A cohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in the year 2000. They all answered pain and cognition questions in years, 1998 and 2000.

Data analysis was done between June 24 and October 31, 2016."Persistent pain," defined as a participant reporting that he or she was often troubled with moderate or severe pain in both the 1998 and 2000 interviews. Co-primary outcomes were composite memory score and dementia probability, estimated by combining neuropsychological test results and informant and proxy interviews, which were tracked from 2000 through 2012. Linear mixed-effects models, with random slope and intercept for each participant, were used to estimate the association of persistent pain with the slope of the subsequent cognitive trajectory, adjusting for demographic characteristics and comorbidities measures in 2000 and applying sampling weights to represent the 2000 US population. It was hypothesized that persistent pain would predict accelerated memory decline and increased the probability of dementia. To quantify the impact of persistent pain on functional independence, primary results with information on the association between memory and ability to manage medications and finances independently were combined.

Results: 

Of 10 065 eligible HRS sample members, 60% were female, and median baseline age was 73 years (interquartile range, 67-78 years). At baseline, persistent pain affected 10.9% of participants and was associated with worse depressive symptoms and more limitations in activities of daily living.

After covariate adjustment, persistent pain was associated with 9.2% (95% CI, 2.8%-15.0%) more rapid memory decline compared with those without persistent pain. After ten years, this accelerated memory decline implied a 15.9% higher relative risk of inability to manage medications and an 11.8% higher relative risk of inability to manage finances independently. Adjusted dementia probability increased 7.7% faster (95% CI, 0.55%-14.2%); after ten years, this translates to an absolute 2.2% increase in dementia probability for those with persistent pain. 

Conclusion: 

Persistent pain was associated with accelerated memory decline and increased probability of dementia.

Source:

JAMA Intern Med. 2017 Jun 5

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28586818

The original title of the article:

Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders.

Authors:

Whitlock EL; et al.

Log in or register to post comments