Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders.
Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders.
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DOI：
10.1001/jamainternmed.2017.1622
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发表时间：
2017-08-01
影响因子：
39
通讯作者：
Smith AK
中科院分区：
文献类型：
--
作者：
Whitlock EL;Diaz-Ramirez LG;Glymour MM;Boscardin WJ;Covinsky KE;Smith AK
Chronic pain is common among the elderly, and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown. To determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline. Cohort study with biennial interviews Community-dwelling older adults in the nationally representative Health and Retirement Study (HRS) 10,065 HRS participants 62 years of age or older in 2000 who answered pain and cognition questions in both 1998 and 2000 “Persistent pain”, defined as a participant reporting he/she was often troubled with moderate or severe pain in both the 1998 and 2000 interviews. Coprimary outcomes were composite memory score and dementia probability, estimated by combining neuropsychological tests and informant and proxy interviews, which were tracked from 2000–2012. Linear mixed effects models, with random slope and intercept for each participant, were used to estimate the association of persistent pain with slope of the subsequent cognitive trajectory, adjusting for demographics and comorbidities measures in 2000 and applying sampling weights to represent the 2000 US population. We hypothesized that persistent pain would predict accelerated memory decline and increased probability of dementia. To quantify the impact of persistent pain on functional independence, we combined our primary results with information on the association between memory and ability to manage medications and finances independently. At baseline, persistent pain affected 10.9% of participants and was associated with worse depressive symptoms and more limitations in activities of daily living. After covariate adjustment, persistent pain was associated with 9.2% (95% CI 2.8–15.0%) more rapid memory decline compared to those without persistent pain. After 10 years, this accelerated memory decline implied a 15.9% higher relative risk of inability to manage medications and a 11.8% higher relative risk of inability to manage finances independently. Adjusted dementia probability increased 7.7% faster (95% CI 0.5–14.2%); after 10 years, this translates to an absolute 2.2% increase in dementia probability for those with persistent pain. Persistent pain is associated with accelerated memory decline and increased probability of dementia.
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影响因子：
7.4
作者：
Elliott, AM;Smith, BH;Chambers, WA
通讯作者：
Chambers, WA
影响因子：
5.7
作者：
Langa, KM;Plassman, BL;Willis, RJ
通讯作者：
Willis, RJ
DOI：
10.1111/j.1532-5415.2004.52104.x
发表时间：
2004-03-01
影响因子：
6.3
作者：
Royall, DR;Palmer, R;Polk, MJ
通讯作者：
Polk, MJ
影响因子：
5.7
作者：
Lopez, Oscar L;Kuller, Lewis H
通讯作者：
Kuller, Lewis H
影响因子：
6.9
作者：
JORM, AF
通讯作者：
JORM, AF