Both persistent pain and cognitive decline increase in prevalence with advancing age and are associated with functional decline. The association of pain and cognitive decline has not been evaluated yet by a systematic assessment of longitudinal studies. This study aimed to assess the association of persistent pain as a risk factor for cognitive decline in community-dwelling older adults, using data from longitudinal studies in a systematic review and meta-analysis. Publications were identified using a systematic search on PubMed, EMBASE, and Cochrane Library databases from inception to June 2019. Because heterogeneity across studies was high, the authors used random-effects meta-analysis to calculate the pooled relative risk of the association between persistent pain and cognitive decline incidence. The authors also investigated sources of heterogeneity among studies using meta-regression and stratified analyses. They included 10 prospective longitudinal studies with a total of 57,495 participants; mean age at baseline ranged from 61.8 to 88.4 years, while mean follow-up times ranged from 2.75 to 11.8 years. Persistent pain at baseline was not associated with the development of cognitive decline during the follow-up (pooled relative risk = 1.05, 95% confidence interval = 0.92-1.21). In sensitivity analyses, only length of follow-up time ≤4.5 years was associated with a higher risk of cognitive impairment (pooled relative risk = 1.19, 95% confidence interval = 1.10-1.28). Persistent pain was not associated with an increased incidence of cognitive decline.
De Aguiar GPCG, Saraiva MD, Khazaal EJB, De Andrade DC, Jacob-Filho W, Suemoto CK. Persistent pain and cognitive decline in older adults: A systematic review and meta-analysis from longitudinal studies. Pain. 2020;161(10):2236-2247.
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