Persistent moderate to severe pain and long‐term cognitive decline

Abstract

Background: The longitudinal association between persistent moderate to severe pain and subsequent long-term cognitive decline remains inconclusive. Methods: Study population came from the English Longitudinal Study of Ageing, an ongoing prospective and nationally representative cohort of community-dwelling adults aged ≥50 years in England. At waves 1 (2002/2003) and 2 (2004/2005) of the study, pain severity was measured based on pain intensity scores ranged from 0 to 10. We defined moderate to severe pain as pain intensity scores ≥5 points. Persistent moderate to severe pain was defined as participants reported moderate to severe pain at both waves 1 and 2. Standardized global cognitive Z scores derived from verbal memory, temporal orientation and semantic fluency were used as the primary outcome. Results: A total of 6,869 individuals (3,896 women; mean age: 63.9 ± 9.5 years) who have accepted twice measurements of pain at waves 1 and 2 (baseline), and at least one reassessment of cognitive function at waves 3 (2006/2007) to 8 (2016/2017), were included in this study. Each 5-point increase in the sum of pain intensity scores was associated with a faster rate of -0.009 (95% CI: -0.013 to -0.006, p < .001) in global cognitive Z scores. Compared with no pain group, persistent moderate to severe pain group was associated with a significantly faster decline rate of -0.031 SD/year (95% CI: -0.043 to -0.018), in global cognitive Z scores. The relationships of persistent moderate to severe pain with verbal memory, temporal orientation and semantic fluency were similar. Conclusion: Cognitive function should be monitored in individuals with persistent moderate to severe pain.

Chronic pain and long‐term dementia risk in older adults: Results from a 24‐year longitudinal study

“…This result could be considered as an indirect measure of pain interference with daily activities. Furthermore, it cannot be excluded that our results are underpowered due to a relatively small sample size, compared to previous studies 7,9 showing a small increased risk of dementia associated with CP.…”

“…Few longitudinal studies have addressed this link prospectively. In two studies CP predicted memory decline 7,8 or accelerated cognitive decline 9 . In our recent study assessing the link between CP and several cognitive functions within a 15‐year follow‐up period, CP was associated with greater decline exclusively in a processing speed test 10 …”

Bidirectional Relationship Between Body Pain and Depressive Symptoms: A Pooled Analysis of Two National Aging Cohort Studies

“…The ELSA sample was from the Health Survey for England, which randomly enrolled individuals who aged 50 years or older and were living in England using the postcode ( 13 , 16 ). The baseline of the ELSA cohort was wave 1 (2002/2003) and the follow-up waves included waves from 2 to 8 (2004/2005 to 2016/2017) ( 17 ).…”

“…In the ELSA cohort, pain intensity was measured based on pain intensity scores ranging from 0 to 10 (0 was no pain and 10 was severe or excruciating pain). Four specific pain locations have been evaluated in the ELSA: back, hips, knees, and feet ( 17 ). For pooling analyses in this study, we divided the ELSA participants into three categories of pain intensity according to the pain intensity scores: no (scored 0), mild to moderate (scored 1–7), and severe pain (scored 8–10).…”

Yes, no, maybe: Replication and the importance of methodology

“…This journal recently published a paper by Rong et al, entitled 'Persistent moderate to severe pain and long-term cognitive decline'. (Rong et al, 2021). The authors demonstrate that, to a small but statistically significant degree, older adults with persistent moderate-to-severe pain (an approximation for chronic pain) experience a faster rate of late-life cognitive decline than older adults without pain.…”