Guusje van der Leeuw1, Laura H P Eggermont2, Ling Shi1, William P Milberg3, Alden L Gross4, Jeffrey M Hausdorff5, Jonathan F Bean6, Suzanne G Leveille7. 1. College of Nursing and Health Sciences, University of Massachusetts Boston. 2. Department of Clinical Neuropsychology, Vrije University, Amsterdam, The Netherlands. 3. Geriatric Neuropsychology Laboratory, Geriatric, Research, Education and Clinical Center, Brockton/West Roxbury Department of Veterans Affairs Medical Center, Boston, Massachusetts. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Center on Aging and Health, Baltimore, Maryland. 5. Laboratory for Gait and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel. Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Israel. 6. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts. New England Geriatric, Research, Education and Clinical Center, Boston Veterans Administration Health System, Massachusetts. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts. 7. College of Nursing and Health Sciences, University of Massachusetts Boston. Department of Medicine, Harvard Medical School, Boston, Massachusetts. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Suzanne.leveille@umb.edu.
Abstract
BACKGROUND: Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. METHODS: We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. RESULTS: Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. CONCLUSIONS: Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults.
BACKGROUND:Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. METHODS: We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. RESULTS: Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. CONCLUSIONS: Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults.
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