Monday, June 5, 2017

Chronic Pain May Accelerate Memory Decline, Study Reports

Older adults troubled by persistent pain may be at a greater risk of rapid memory decline, according to a study published today in JAMA Internal Medicine.

“Whereas it is known that chronic pain is associated with poorer cognitive performance in cross-sectional studies, this study newly demonstrates accelerated memory decline and increased probability of developing dementia year-on-year at a population level,” wrote Elizabeth Whitlock, M.D., of the University of California, San Francisco, and colleagues. 

Whitlock and colleagues analyzed data collected as part of the Health and Retirement Study (HRS)—a nationally representative cohort of community-dwelling older adults who undergo detailed in-person or telephone interviews every two years. The researchers focused on adults who were 62 years or older in 2000 and answered pain and cognition questions in 1998 and 2000; those reporting being “often troubled by moderate or severe pain” both years were classified as having “persistent pain.” Participants were followed until death, dropout, or evaluation in 2012.

Of the 10,065 adults included in the sample, 1,120 (10.9% of the weighted sample) reported persistent pain at baseline. Participants reporting persistent pain had more depressive symptoms, a greater prevalence of limitations in activities of daily living, and more comorbid medical conditions than those not experiencing pain. 

“Over time, participants with persistent pain experienced a 9.2% more rapid decline in memory score. This translated to a relative 11.8% to 15.9% increased risk of inability to manage medications or finances independently at the end of 10 years, compared with age-adjusted HRS peers,” Whitlock and colleagues wrote. Additionally, “population-level dementia probability increased 7.7% faster in those with persistent pain compared with those without.”

The authors concluded, “For the elderly, maintenance of cognition is crucial for quality of life and functional independence. … Elucidating the nature of the relationship between pain and cognitive decline is the first step toward developing strategies to mitigate it.”

For related information, see the Psychiatric News article “New Dementia Measures Address Disclosure of Diagnosis to Patients.”

(Image: Richard Lyons/Shutterstock)


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