4.4 Article

Does Cognitive Functioning Predict Chronic Pain in Older Adult? Results From the CoLaus|PsyCoLaus Longitudinal Study

Journal

JOURNAL OF PAIN
Volume 22, Issue 8, Pages 905-913

Publisher

CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2021.01.007

Keywords

Chronic pain; cognition; executive function; cohort

Funding

  1. GlaxoSmithKline
  2. Faculty of Biology and Medicine of Lausanne
  3. Swiss National Science Foundation [3200B0 -105993, 3200B0118308, 33CSCO122661, 33CS30139468, 33CS30-148401, 33CS30_177535/1]

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This study prospectively assessed the association between cognitive functioning and the occurrence of chronic pain in older community dwellers. Results suggest that patients with inhibitory deficits may be at higher risk of developing chronic pain in the presence of painful events. A cognitive assessment should be recommended to identify and manage frail patients in these situations.
Chronic pain (CP) and cognitive impairment are common in older adults. CP was found to be associated with cognitive impairment in many cross-sectional studies. However, their cross-sectional design precluded inference on temporality. Accordingly, we aimed to prospectively assess the association between cognitive functioning and the occurrence of CP in older community dwellers. Analyses were based on data of the first (FU1) and the second follow-up (FU2) of CoLaus vertical bar PsyCoLaus, a prospective cohort study conducted in the general population of Lausanne (Switzerland) including the participants aged 65 and over. Neuropsychological functioning including memory, language, attention and executive function was measured at FU1. CP was assessed at FU1 and FU2 by self-rating questionnaire. The association between cognitive scores and subsequent CP was determined using multiple logistic regressions. Among the 337 participants without CP at FU1, 107 (31.8%) developed CP at FU2. A significant association was observed between higher Stroop color-time and interference index at FU1 and a higher risk of CP at FU2 (OR = 1.02; P= .03 and OR = 1.49; P= .03, respectively). Our results suggest that patients with inhibitory deficit may be at higher risk of developing CP in the presence of painful events. A cognitive assessment could be recommended to identify frail patients in these situations. Perspective: This study suggests that presence of inhibitory deficits is associated with a higher risk of developing subsequent CP in older adults. In the presence of painful events, a cognitive assessment should be recommended to identify frail patients and to manage them carefully. (C) 2021 by United States Association for the Study of Pain, Inc.

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