Persistent pain is associated with more rapid memory decline and increased risk of dementia, according to an analysis of the Health and Retirement Study.

American researchers investigated the link in 10,065 people (60 per cent female) with a median age of 73 years who answered questions about pain and cognition in 1998 and 2000. “Persistent pain” was defined as being “often troubled with moderate or severe pain”.

One in 10 people (10.9 per cent) suffered from persistent pain, which was associated with worse depressive symptoms and more limitations in activities of daily living.

Persistent pain was associated with a 9.2 per cent more rapid memory decline than in those without persistent pain. After 10 years, this accelerated memory decline translated into a 15.9 per cent higher relative risk of inability to manage medications and an 11.8 per cent higher risk of inability to manage finances independently. After 10 years, this corresponds to a 2.3 and 1.4 per cent higher risk of being unable to manage finances and medications independently.

The probability of having dementia also increased 7.7 per cent more rapidly in those with persistent pain. Several factors may account for the link. Certain analgesics can impair attention and memory, while pain can also have a direct effect. Pain may, for example, directly compete for cognitive processing, diverting attention, especially when pain is severe and in patients who tend to ruminate about pain.

JAMA Intern Med doi:10.1001/jamainternmed.2017.1622

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