Dementia risk increases if you live with chronic pain, study finds


According to a new study, chronic pain, such as arthritis, cancer or back pain, that lasts more than three months, increases the risk of cognitive decline and dementia.

The hippocampus, a brain structure strongly associated with learning and memory, aged about a year in a 60-year-old person who had a site of chronic pain compared to people without pain.

When pain was felt in two places in the body, the hippocampus shrank even more – the equivalent of just over two years of aging, according to the study’s estimates published Monday in the journal Proceedings of the National Academy. of Science, or PNAS.

“In other words, the hippocampus (gray matter volume) in a 60-year-old individual with (chronic pain) in two body locations was similar to the volume of 62-year-old (pain-free) controls,” said writes the correspondent. author Tu Yiheng and his colleagues. You are a professor of psychology at the Chinese Academy of Sciences in Beijing.

The risk increased as the number of pain sites in the body increased, according to the study. Hippocampal volume was nearly four times smaller in people with pain in five or more body sites compared to those with just two – the equivalent of up to eight years of aging.

“Asking people about any chronic pain condition and advocating for their management by a pain specialist may be a modifiable risk factor for cognitive decline that we can proactively address,” said Dr. Richard Isaacson, researcher on Alzheimer’s disease, preventive neurologist at the Institute. for Florida Neurodegenerative Diseases. He did not participate in the new study.

The study analyzed data from more than 19,000 people who had brain scans as part of the UK Biobank, a long-term government study of more than 500,000 UK participants aged 40 to 69.

According to the study, people with multiple sites of body pain performed worse than people without pain on seven out of 11 cognitive tasks. In contrast, people with only one pain site performed worse on a single cognitive task – the ability to remember to perform a task in the future.

The study controlled for a variety of contributing conditions – age, alcohol consumption, body mass, ethnicity, genetics, history of cancer, diabetes, vascular or heart problems, medications, psychiatric symptoms and smoking status, to name a few. only a few. However, the study did not control for exercise levels, Isaacson said.

“Exercise is the most powerful tool in the fight against cognitive decline and dementia,” he said by email. “People affected by chronic multisite pain may be less able to adhere to regular physical activity as a potential mechanism for increasing dementia risk.”

Living with chronic pain can lead to more rapid cognitive decline and later dementia, according to a new study.

Equally important is a link between chronic pain and inflammation, Isaacson said. A 2019 review of studies found that pain triggers immune cells called microglia to create neuroinflammation which can lead to changes in brain connectivity and function.

People with higher pain levels were also more likely to have reduced gray matter in other areas of the brain that impact cognition, such as the prefrontal cortex and frontal lobe – the same areas attacked by Alzheimer’s disease. In fact, more than 45% of Alzheimer’s patients live with chronic pain, according to a 2016 study cited by the item.

The study was also unable to determine sleep deficits – chronic pain often makes it difficult to get a good night’s sleep. A 2021 study found that sleeping less than six hours a night in midlife increases the risk of dementia by 30%.

Globally, low back pain is one of the leading causes of years lived with disability, with neck pain ranking 4th, according to the 2016 Global Burden of Disease study. Arthritis, nerve damage, cancer pain, and injury are other leading causes.

Researchers estimate that more than 30% of people worldwide suffer from chronic pain: “Pain is the most common reason people seek health care and the leading cause of disability worldwide,” according to researchers. articles published in the journal The Lancet in 2021.

In the United States alone, at least 1 in 5 people, or some 50 million Americans, live with long-lasting pain, according to the United States Centers for Disease Control and Prevention.

Nearly 11 million Americans suffer from high-impact chronic pain, defined as pain that lasts longer than three months and is “accompanied by at least one major activity restriction, such as the inability to work indoors. outside the home, going to school or doing household chores”. according to the National Center for Complementary and Integrative Health.

Chronic pain has been linked to anxiety, depression, restrictions in mobility and daily activities, opioid addiction, increased healthcare costs, and poor quality of life. A 2019 study estimated that approximately 5-8 million Americans use opioids to manage chronic pain.

According to John Hopkins Medicine, pain management programs typically involve a number of specialists to find the best symptom relief while providing support for the emotional and mental burden of pain.

Medical treatment may include over-the-counter and prescription medications to stop the pain cycle and relieve inflammation. Steroid injections can also help. Antidepressants increase the amount of serotonin, which controls part of the pain pathway in the brain. Another treatment is the application of brief bursts of electricity to muscles and nerve endings.

Therapies such as massage and hot tub immersion and exercises can be suggested by occupational therapists and physiotherapists. Hot and cold treatments and acupuncture can also help.

Rehabilitation psychologists can recommend cognitive and relaxation techniques such as meditation, tai chi, and yoga that can distract the mind from fixation on pain. Cognitive-behavioral therapy is a key psychological treatment for pain.

An anti-inflammatory cure may be suggested, such as reducing trans fats, sugars, and other processed foods. Weight loss can also be helpful, especially for back and knee pain, according to Johns Hopkins.

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