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Pain is not associated with cognitive decline in older adults: A four-year longitudinal study

Pain is not associated with cognitive decline in older adults: A four-year longitudinal study
Pain is not associated with cognitive decline in older adults: A four-year longitudinal study

The finding of a potential association between pain and cognitive decline is limited to a few cross-sectional studies with relatively samples. We therefore aimed to investigate whether the presence and severity of pain at baseline could predict a decline in cognitive function over four years of follow-up in the English Longitudinal Study of Ageing. At baseline, participants with no dementia who were “often troubled by pain” were considered to have pain. Pain severity was categorized as mild, moderate, or severe. Cognitive function was explored through verbal fluency (assessed by asking how many different animals the participants could name in 60 s), memory (sum of immediate and delayed verbal memory) and processing speed (number of target letters correctly identified on the letter cancellation task). Multivariable linear regression was used (exposure: pain; outcomes: cognitive change between follow-up and baseline, based on standardized residuals). Altogether, 6515 community-dwelling people with a mean age of 65 years (women = 57.3%) were included. Over a 4-year follow-up, after adjusting for 26 potential confounders, no association between pain (yes vs. no) and verbal fluency (beta = 0.02; 95%CI: −0.15 to 0.18), memory (0.05; 95%CI: −0.28 to 0.38), or processing speed (0.55; 95%CI: −18.4 to 2.93) at follow-up was found. Only severe pain was associated with greater decline in memory (−0.36; 95%CI: −0.68 to −0.04). In conclusion, in older people, pain was not associated with worsening in cognition, except for severe pain, which was marginally associated with worsening in memory tests. Further longitudinal studies are needed to confirm or refute our findings.

Cognitive decline, Elderly, Memory, Pain
0378-5122
92-96
Veronese, Nicola
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Koyanagi, Ai
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Solmi, Marco
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Thompson, Trevor
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Maggi, Stefania
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Schofield, Patricia
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Mueller, Christoph
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Gale, Catharine R.
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Cooper, Cyrus
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Stubbs, Brendon
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Veronese, Nicola
a9a97f63-a828-45a3-bae0-68182c5a44fd
Koyanagi, Ai
217cfa42-a476-47d9-b158-4cfc6aed2719
Solmi, Marco
2022a2e4-774d-4811-b1db-b6dbfedbd10d
Thompson, Trevor
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Maggi, Stefania
269c4058-6259-4392-a884-4fca4ffe5c68
Schofield, Patricia
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Mueller, Christoph
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Gale, Catharine R.
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Cooper, Cyrus
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Stubbs, Brendon
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Veronese, Nicola, Koyanagi, Ai, Solmi, Marco, Thompson, Trevor, Maggi, Stefania, Schofield, Patricia, Mueller, Christoph, Gale, Catharine R., Cooper, Cyrus and Stubbs, Brendon (2018) Pain is not associated with cognitive decline in older adults: A four-year longitudinal study. Maturitas, 115, 92-96. (doi:10.1016/j.maturitas.2018.07.001).

Record type: Article

Abstract

The finding of a potential association between pain and cognitive decline is limited to a few cross-sectional studies with relatively samples. We therefore aimed to investigate whether the presence and severity of pain at baseline could predict a decline in cognitive function over four years of follow-up in the English Longitudinal Study of Ageing. At baseline, participants with no dementia who were “often troubled by pain” were considered to have pain. Pain severity was categorized as mild, moderate, or severe. Cognitive function was explored through verbal fluency (assessed by asking how many different animals the participants could name in 60 s), memory (sum of immediate and delayed verbal memory) and processing speed (number of target letters correctly identified on the letter cancellation task). Multivariable linear regression was used (exposure: pain; outcomes: cognitive change between follow-up and baseline, based on standardized residuals). Altogether, 6515 community-dwelling people with a mean age of 65 years (women = 57.3%) were included. Over a 4-year follow-up, after adjusting for 26 potential confounders, no association between pain (yes vs. no) and verbal fluency (beta = 0.02; 95%CI: −0.15 to 0.18), memory (0.05; 95%CI: −0.28 to 0.38), or processing speed (0.55; 95%CI: −18.4 to 2.93) at follow-up was found. Only severe pain was associated with greater decline in memory (−0.36; 95%CI: −0.68 to −0.04). In conclusion, in older people, pain was not associated with worsening in cognition, except for severe pain, which was marginally associated with worsening in memory tests. Further longitudinal studies are needed to confirm or refute our findings.

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pain and memory - Accepted Manuscript
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Accepted/In Press date: 1 July 2018
e-pub ahead of print date: 3 July 2018
Published date: 1 September 2018
Keywords: Cognitive decline, Elderly, Memory, Pain

Identifiers

Local EPrints ID: 422559
URI: http://eprints.soton.ac.uk/id/eprint/422559
ISSN: 0378-5122
PURE UUID: 32f7dae1-8d86-418a-91c9-9fe0d68de224
ORCID for Catharine R. Gale: ORCID iD orcid.org/0000-0002-3361-8638
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 25 Jul 2018 16:30
Last modified: 18 Feb 2021 16:48

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Contributors

Author: Nicola Veronese
Author: Ai Koyanagi
Author: Marco Solmi
Author: Trevor Thompson
Author: Stefania Maggi
Author: Patricia Schofield
Author: Christoph Mueller
Author: Cyrus Cooper ORCID iD
Author: Brendon Stubbs

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