TY - JOUR
T1 - The Effect of Pain on Major Cognitive Impairment in Older Adults
AU - van der Leeuw, Guusje
AU - Ayers, Emmeline
AU - Leveille, Suzanne G.
AU - Blankenstein, Annette H.
AU - van der Horst, Henriette E.
AU - Verghese, Joe
N1 - Funding Information:
Supported by funds from the National Institutes of Health, National Institute on Aging (grant numbers R01AG036921-01A1 and R01AG044007-01A1). G.L. is supported by the intramural grant from the Resnick Gerontology Center, Albert Einstein College of Medicine, Yeshiva University. Additional scholarships were provided by the ?Stichting Stoffels-Hornstra,? ?Fundatie van Beijeren van Schagen,? and ?Dr. Catharine van Tussenbroek fonds.? The funding source had no influence on the conduct and design of the study, neither on the data collection, analysis, the interpretation of the data, the approval of the manuscript, or in the decision to submit the article for publication.
Funding Information:
Supported by funds from the National Institutes of Health, National Institute on Aging (grant numbers R01AG036921-01A1 and R01AG044007-01A1 ). G.L. is supported by the intramural grant from the Resnick Gerontology Center, Albert Einstein College of Medicine, Yeshiva University. Additional scholarships were provided by the “Stichting Stoffels-Hornstra,” “Fundatie van Beijeren van Schagen,” and “Dr. Catharine van Tussenbroek fonds.” The funding source had no influence on the conduct and design of the study, neither on the data collection, analysis, the interpretation of the data, the approval of the manuscript, or in the decision to submit the article for publication.
Publisher Copyright:
© 2018 the American Pain Society
PY - 2018/12
Y1 - 2018/12
N2 - Older adults frequently report pain; cross-sectional studies have shown that pain is associated with worse cognitive function. However, longitudinal studies are lacking. We prospectively studied 441 participants without dementia, including 285 with pain, aged 65 years and older, enrolled in the Central Control of Mobility in Aging study, a prospective cohort study. We analyzed the longitudinal association between pain (measured with the Medical Outcomes Study pain severity scale) and major cognitive impairment (measured with the Repeatable Battery for the Assessment of Neuropsychological Status and the Trail Making Test Delta) using Cox regression analysis adjusted for age, gender, ethnicity, and education. Over a mean follow-up of 2.75 years (standard deviation = 1.94), there was no difference in the risk of developing cognitive impairment between participants with pain and participants without pain. However, among those with pain, risk for developing major memory impairment was higher among those with high levels of pain than those with low levels of pain (adjusted hazard ratio = 3.47, 95% confidence interval = 1.42–8.46). The association with pain and incident impairments in attention or executive function was not significant. We did not find that pain is associated with incident cognitive impairment in general, but among older adults with pain, a high level of pain is associated with increased risk of developing incident memory impairment. Perspective: Our study results suggest that high levels of pain may contribute to incident memory impairment. Further research is needed to determine whether a high level of chronic pain is a modifiable risk factor for cognitive impairment in older adults.
AB - Older adults frequently report pain; cross-sectional studies have shown that pain is associated with worse cognitive function. However, longitudinal studies are lacking. We prospectively studied 441 participants without dementia, including 285 with pain, aged 65 years and older, enrolled in the Central Control of Mobility in Aging study, a prospective cohort study. We analyzed the longitudinal association between pain (measured with the Medical Outcomes Study pain severity scale) and major cognitive impairment (measured with the Repeatable Battery for the Assessment of Neuropsychological Status and the Trail Making Test Delta) using Cox regression analysis adjusted for age, gender, ethnicity, and education. Over a mean follow-up of 2.75 years (standard deviation = 1.94), there was no difference in the risk of developing cognitive impairment between participants with pain and participants without pain. However, among those with pain, risk for developing major memory impairment was higher among those with high levels of pain than those with low levels of pain (adjusted hazard ratio = 3.47, 95% confidence interval = 1.42–8.46). The association with pain and incident impairments in attention or executive function was not significant. We did not find that pain is associated with incident cognitive impairment in general, but among older adults with pain, a high level of pain is associated with increased risk of developing incident memory impairment. Perspective: Our study results suggest that high levels of pain may contribute to incident memory impairment. Further research is needed to determine whether a high level of chronic pain is a modifiable risk factor for cognitive impairment in older adults.
KW - Cognitive function
KW - cognitive impairment
KW - epidemiology
KW - neuropsychology
KW - pain severity
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U2 - 10.1016/j.jpain.2018.06.009
DO - 10.1016/j.jpain.2018.06.009
M3 - Article
C2 - 30004021
AN - SCOPUS:85052930802
VL - 19
SP - 1435
EP - 1444
JO - Journal of Pain
JF - Journal of Pain
SN - 1526-5900
IS - 12
ER -