The Effect of Pain on Major Cognitive Impairment in Older Adults

Guusje van der Leeuw, Emmeline I. Ayers, Suzanne G. Leveille, Annette H. Blankenstein, Henriette E. van der Horst, Joe Verghese

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalJournal of Pain
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Pain
Cognitive Dysfunction
Trail Making Test
Executive Function
Chronic Pain
Cognition
Longitudinal Studies
Dementia
Cohort Studies
Cross-Sectional Studies
Regression Analysis
Outcome Assessment (Health Care)
Prospective Studies
Confidence Intervals
Education
Research

Keywords

  • Cognitive function
  • cognitive impairment
  • epidemiology
  • neuropsychology
  • pain severity

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

van der Leeuw, G., Ayers, E. I., Leveille, S. G., Blankenstein, A. H., van der Horst, H. E., & Verghese, J. (Accepted/In press). The Effect of Pain on Major Cognitive Impairment in Older Adults. Journal of Pain. https://doi.org/10.1016/j.jpain.2018.06.009

The Effect of Pain on Major Cognitive Impairment in Older Adults. / van der Leeuw, Guusje; Ayers, Emmeline I.; Leveille, Suzanne G.; Blankenstein, Annette H.; van der Horst, Henriette E.; Verghese, Joe.

In: Journal of Pain, 01.01.2018.

Research output: Contribution to journalArticle

van der Leeuw, Guusje ; Ayers, Emmeline I. ; Leveille, Suzanne G. ; Blankenstein, Annette H. ; van der Horst, Henriette E. ; Verghese, Joe. / The Effect of Pain on Major Cognitive Impairment in Older Adults. In: Journal of Pain. 2018.
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