August 14, 2018
By Lorraine L. Janeczko
NEW YORK (Reuters Health) - Older adults with high levels of pain are more likely to develop impaired memory than those with low levels of pain, a new study suggests.
"These findings provide evidence that pain is a (potentially modifiable) risk factor for memory impairment, and they underline the importance of monitoring pain in older adults," lead author Dr. Guusje van der Leeuw of Albert Einstein College of Medicine in New York City told Reuters Health by email.
Dr. van der Leeuw and colleagues prospectively studied 441 participants without dementia who were at least 65 years old and were enrolled in the single-center Central Control of Mobility in Aging Study. They analyzed the link between scores on the Medical Outcomes Study pain severity scale and the Repeatable Battery for the Assessment of Neuropsychological Status and the Trail Making Test Delta.
Over a mean follow-up of 2.75 years, there was no difference in the risk of developing cognitive impairment between the 285 participants with pain and the 156 without, the researchers report in The Journal of Pain, online July 10.
But among those with pain, the likelihood of developing major memory impairment was more than three times higher for those with high levels of pain than for those with low levels of pain after adjusting for age, gender, education and ethnicity (hazard ratio, 3.47).
"Pain is common, affecting over half of community-dwelling older adults," Dr. Van der Leeuw said. "Previous research has shown that pain can affect cognition. This can partly be explained because pain demands attention and takes precedence over other cognitive functions. However, it is unknown if pain has long-term effects on cognition."
Dr. Douglas Scharre, director of the division of cognitive neurology at The Ohio State University Wexner Medical Center in Columbus, said he was not too surprised by the results because pain as well as analgesic and psychotropic use can influence cognitive abilities.
"It would be useful to know if those with severe pain were on higher doses of analgesics, which could influence cognition," Dr. Scharre, who was not involved in the study, told Reuters Health by email. "If analgesics use declines over time, does that improve risk of incident cognitive impairment?"
Dr. Howard L. Feinberg, a professor of rheumatology at Touro University College of Osteopathic Medicine in Vallejo, California, who also was not involved in the study, said the results help "direct physicians to treat the pain that could affect memory and avoid treatments for pain (which could make memory worse) when they are not needed."
"Pain is very subjective and often influenced by culture," he cautioned in an email to Reuters Health. "Although the study used a standard pain assessment, these results will need to be reviewed and repeated on other populations who have different socioeconomic backgrounds, cultural backgrounds, and are in different regions of the country, to be verified."
J Pain 2018.
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