Incident Functional Limitations Among Community-Dwelling Adults Using Opioids: A Retrospective Cohort Study Using a Propensity Analysis with the Health and Retirement Study

Pritchard, Kevin; Downer, Brian; Raji, Mukaila; Baillargeon, Jacques; Kuo, Yong‐Fang

doi:10.1007/s40266-022-00953-y

Cited by 4 publications

(1 citation statement)

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“…13 However, this study lacked information on pain, so this greater dementia risk may be due to residual chronic pain, rather than the pain treatment itself. 13 Other studies found no relationship between opioid use and cognitive decline 45 or ADRD. 14 Few studies have assessed the potential mediating role of depression or depressive symptomatology.…”

Section: Discussionmentioning

confidence: 99%

Pain and incident cognitive impairment in very old Mexican American adults

Milani,

Sanchez,

Kuo

et al. 2023

J American Geriatrics Society

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BackgroundStudies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity‐limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80.MethodsData were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010–2016). Pain interference, or pain that limited daily activities in the last 12 months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring <21 on the Mini‐Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6‐year period (n = 313).ResultsParticipants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09–4.36; treated aOR: 1.99; 95% CI: 1.15–3.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain.ConclusionsAmong very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non‐pharmacological treatments in these pathways.

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