Using data from the Health and Retirement Study, scientists discovered that chronic pain in the elderly increases the risk of developing dementia.
Persistent, or chronic pain affects 25% to 33% of older adults and is defined as reporting that one is often troubled with moderate or severe pain. It is associated with depression, falls, and memory impairment, but can it increase an individual’s risk of developing dementia? Scientists in California set out to answer that question using data obtained from the nationally representative Health and Retirement Study (HRS). They hypothesized that chronic pain would increase the chances of developing dementia and their study showed that this is indeed the case.
The HRS is a long-term cohort study that interviewed 10 065 community-dwelling older adults over 62 years of age every two years, giving it great power to study how an individual’s health can change over time. The researchers analyzed reports of people who reported moderate or severe pain in both 1998 and 2000 and compared them 10 years later to those who had never reported chronic pain.
Participants who reported chronic pain had an almost 10% decrease in their memory score after ten years, compared to those who did not report chronic pain. These participants were also 8% more likely to be diagnosed with dementia. In addition, chronic pain patietns had a 12% higher risk of reporting difficulties managing their money and a 16% higher risk of an inability to manage their own medications compared with those who had never experienced chronic pain.
The researchers identified three possible reasons for this association. First, it is possible that a related variable causes the association. For example, those with chronic pain are most likely prescribed medications to mitigate the pain such as opioids, and these medications could be contributing to the increase in dementia. Secondly, the pain itself could be affecting the ability of the brain to function properly, leading to memory loss and dementia. Lastly, it is possible that a confounding variable is contributing to both conditions, pain and the dementia. Many interrelated variables, such as depression, could be contributing to these conditions. Further research is necessary to determine whether there is a pathway directly linking chronic pain to dementia.
This study is important because it will help health care professionals to identify elders who are at risk of cognitive decline and dementia. The maintenance of cognition is crucial for independence and quality of life in elderly patients. As health care professionals assess for pain they can appropriately suggest treatment strategies to mitigate the risk of dementia
Written By: Lisa Borsellino, B.Sc.