Pain and incident cognitive impairment in very old Mexican American adults.
aging
dementia
ethnicity
pain
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
05 Oct 2023
05 Oct 2023
Historique:
revised:
21
08
2023
received:
10
03
2023
accepted:
06
09
2023
medline:
5
10
2023
pubmed:
5
10
2023
entrez:
5
10
2023
Statut:
aheadofprint
Résumé
Studies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity-limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80. Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010-2016). Pain interference, or pain that limited daily activities in the last 12 months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring <21 on the Mini-Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6-year period (n = 313). Participants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09-4.36; treated aOR: 1.99; 95% CI: 1.15-3.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain. Among very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non-pharmacological treatments in these pathways.
Sections du résumé
BACKGROUND
BACKGROUND
Studies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity-limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80.
METHODS
METHODS
Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010-2016). Pain interference, or pain that limited daily activities in the last 12 months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring <21 on the Mini-Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6-year period (n = 313).
RESULTS
RESULTS
Participants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09-4.36; treated aOR: 1.99; 95% CI: 1.15-3.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain.
CONCLUSIONS
CONCLUSIONS
Among very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non-pharmacological treatments in these pathways.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIA NIH HHS
ID : P30AG024832
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG10939
Pays : United States
Organisme : NIMHD NIH HHS
ID : R01 MD010355
Pays : United States
Organisme : NIA NIH HHS
ID : K01AG075254
Pays : United States
Organisme : NIDA NIH HHS
ID : R01DA039192
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG024832
Pays : United States
Organisme : NIA NIH HHS
ID : RF1AG068988
Pays : United States
Organisme : NIMHD NIH HHS
ID : R01MD010355
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG059301
Pays : United States
Informations de copyright
© 2023 The American Geriatrics Society.
Références
Matthews KA, Xu W, Gaglioti AH, et al. Racial and ethnic estimates of Alzheimer's disease and related dementias in the United States (2015-2060) in adults aged ≥65 years. Alzheimers Dement. 2019;15(1):17-24.
Ezzati A, Wang C, Katz MJ, et al. The temporal relationship between pain intensity and pain interference and incident dementia. Curr Alzheimer Res. 2019;16(2):109-115.
Moriarty O, McGuire BE, Finn DP. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol. 2011;93(3):385-404.
van der Leeuw G, Eggermont LH, Shi L, et al. Pain and cognitive function among older adults living in the community. J Gerontol A Biol Sci Med Sci. 2016;71(3):398-405.
Whitlock EL, Diaz-Ramirez LG, Glymour MM, Boscardin WJ, Covinsky KE, Smith AK. Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders. JAMA Intern Med. 2017;177(8):1146-1153.
Milani SA, Bell TR, Crowe M, Pope CN, Downer B. Increasing pain interference is associated with cognitive decline over four years among older Puerto Rican adults. J Gerontol A Biol Sci Med Sci. 2023;78(6):1005-1012.
Bell T, Franz CE, Kremen WS. Persistence of pain and cognitive impairment in older adults. J Am Geriatr Soc. 2022;70(2):449-458.
van der Leeuw G, Ayers E, Leveille SG, Blankenstein AH, van der Horst HE, Verghese J. The effect of pain on major cognitive impairment in older adults. J Pain. 2018;19(12):1435-1444.
Khalid S, Sambamoorthi U, Innes KE. Non-cancer chronic pain conditions and risk for incident Alzheimer's disease and related dementias in community-dwelling older adults: a population-based retrospective cohort study of United States Medicare beneficiaries, 2001-2013. Int J Environ Res Public Health. 2020;17(15):5454.
de Aguiar G, 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.
Rouch I, Edjolo A, Laurent B, Dartigues JF, Amieva H. Chronic pain and long-term dementia risk in older adults: results from a 24-year longitudinal study. Int J Geriatr Psychiatry. 2022;37(5):1-10.
Pritchard KT, Baillargeon J, Raji MA, Chou L-N, Downer B, Kuo Y-F. Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: a retrospective cohort study of Medicare enrollees. Arch Phys Med Rehabil. 2021;102(7):1257-1266.
Dublin S, Walker RL, Gray SL, et al. Prescription opioids and risk of dementia or cognitive decline: a prospective cohort study. J Am Geriatr Soc. 2015;63(8):1519-1526.
Taipale H, Hamina A, Lampela P, et al. Is Alzheimer's disease associated with previous opioid use? Pain Med. 2018;19(11):2115-2121.
Frey WH. The US will become ‘minority white’ in 2045, Census projects: youthful minorities are the engine of future growth; 2018.
Noe-Bustamante L. Key facts about U.S. Hispanics and their diverse heritage. Published 2019. Accessed November 11, 2020. https://www.pewresearch.org/fact-tank/2019/09/16/key-facts-about-u-s-hispanics/
Garcia MA, Warner DF, García C, Downer B, Raji M. Age patterns in self-reported cognitive impairment among older Latino subgroups and non-Latino Whites in the United States, 1997-2018: implications for public health policy. Innov Aging. 2021;5(4):igab039.
Riskowski JL. Associations of socioeconomic position and pain prevalence in the United States: findings from the National Health and Nutrition Examination Survey. Pain Med. 2014;15(9):1508-1521.
Hollingshead NA, Ashburn-Nardo L, Stewart JC, Hirsh AT. The pain experience of Hispanic Americans: a critical literature review and conceptual model. J Pain. 2016;17(5):513-528.
Hollingshead NA, Vrany EA, Stewart JC, Hirsh AT. Differences in Mexican Americans' prevalence of chronic pain and co-occurring analgesic medication and substance use relative to non-Hispanic White and Black Americans: results from NHANES 1999-2004. Pain Med. 2015;17(6):1001-1009.
Hardt J, Jacobsen C, Goldberg J, Nickel R, Buchwald D. Prevalence of chronic pain in a representative sample in the United States. Pain Med. 2008;9(7):803-812.
Zajacova A, Grol-Prokopczyk H, Fillingim R. Beyond Black vs White: racial/ethnic disparities in chronic pain including Hispanic, Asian, Native American, and multiracial US adults. Pain. 2022;163(9):1688-1699.
Nahin RL. Pain prevalence, chronicity and impact within subpopulations based on both Hispanic ancestry and race: United States, 2010-2017. J Pain. 2021;22:826-851.
Eccleston C, Crombez G. Pain demands attention: a cognitive-affective model of the interruptive function of pain. Psychol Bull. 1999;125(3):356-366.
Miller EK. The prefrontal cortex and cognitive control. Nat Rev Neurosci. 2000;1(1):59-65.
Mesulam MM. From sensation to cognition. Brain. 1998;121(6):1013-1052.
Zimmerman ME, Pan JW, Hetherington HP, Lipton ML, Baigi K, Lipton RB. Hippocampal correlates of pain in healthy elderly adults: a pilot study. Neurology. 2009;73(19):1567-1570.
Sheng J, Liu S, Wang Y, Cui R, Zhang X. The link between depression and chronic pain: neural mechanisms in the brain. Neural Plast. 2017;2017:9724371.
Cao S, Fisher DW, Yu T, Dong H. The link between chronic pain and Alzheimer's disease. J Neuroinflammation. 2019;16(1):204.
Zis P, Daskalaki A, Bountouni I, Sykioti P, Varrassi G, Paladini A. Depression and chronic pain in the elderly: links and management challenges. Clin Interv Aging. 2017;12:709-720.
Gerrits MMJG, van Marwijk HWJ, van Oppen P, van der Horst H, Penninx BWJH. Longitudinal association between pain, and depression and anxiety over four years. J Psychosom Res. 2015;78(1):64-70.
Raji MA, Reyes-Ortiz CA, Kuo Y-F, Markides KS, Ottenbacher KJ. Depressive symptoms and cognitive change in older Mexican Americans. J Geriatr Psychiatry Neurol. 2007;20(3):145-152.
Thomas AJ, O'Brien JT. Depression and cognition in older adults. Curr Opin Psychiatry. 2008;21(1):8-13.
Brown SC, Glass JM, Park DC. The relationship of pain and depression to cognitive function in rheumatoid arthritis patients. Pain. 2002;96(3):279-284.
Lillis TA, Tirone V, Gandhi N, et al. Sleep disturbance and depression symptoms mediate relationship between pain and cognitive dysfunction in lupus. Arthritis Care Res (Hoboken). 2019;71(3):406-412.
Hooker K, Phibbs S, Irvin VL, et al. Depression among older adults in the United States by disaggregated race and ethnicity. Gerontologist. 2019;59(5):886-891.
Boen CE, Hummer RA. Longer-but harder-lives?: the Hispanic health paradox and the social determinants of racial, ethnic, and immigrant-native health disparities from midlife through late life. J Health Soc Behav. 2019;60(4):434-452.
Cantu P, Markides K. Hispanic EPESE (Established Population for the Epidemiological Study of the Elderly). In: Gu D, Dupre ME, eds. Encyclopedia of Gerontology and Population Aging. Springer International Publishing; 2019:1-8.
Markides K, Rudkin L, Angel R, Espino D. Health status of Hispanic elderly in the United States. In: En Martin L, Soldo B, eds. Racial and Ethnic Differences in the Health of Older Americans. National Academy Press; 1997.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
Raji MA, Al Snih S, Ray LA, Patel KV, Markides KS. Cognitive status and incident disability in older Mexican Americans: findings from the Hispanic established population for the Epidemiological Study of the Elderly. Ethn Dis. 2004;14(1):26-31.
Downer B, Al Snih S, Howrey BT, Raji MA, Markides KS, Ottenbacher KJ. Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans. Aging Ment Health. 2019;23(10):1405-1412.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measur. 1977;1(3):385-401.
Kohler U, Karlson KB, Holm A. Comparing coefficients of nested nonlinear probability models. Stata J. 2011;11(3):420-438.
Pritchard KT, Downer B, Raji MA, Baillargeon J, Kuo YF. Incident functional limitations among community-dwelling adults using opioids: a retrospective cohort study using a propensity analysis with the health and retirement study. Drugs Aging. 2022;39(7):559-571.
Jimenez DE, Martinez Garza D, Cárdenas V, Marquine M. Older Latino mental health: a complicated picture. Innov Aging. 2020;4(5):igaa033.
Campbell LC, Andrews N, Scipio C, Flores B, Feliu MH, Keefe FJ. Pain coping in Latino populations. J Pain. 2009;10(10):1012-1019.
Torres CA, Thorn BE, Kapoor S, DeMonte C. An examination of cultural values and pain management in foreign-born Spanish-Speaking Hispanics seeking care at a Federally Qualified Health Center. Pain Med. 2017;18(11):2058-2069.