Variability in every day pain is associated with mild cognitive impairment (MCI): Results from the Einstein Aging Study (EAS)
Year: 2020
Type: article
Study design: Observational Study
Abstract: Background Half of older adults have chronic pain. Pain is a common, biologically plausible, remediable risk factor for cognitive decline and incident dementia. The relation of pain and MCI is under‐explored. Commonly measured dimensions of pain include intensity (how severe is the pain) and interference (how much does pain interfere with activities). Traditional pain measures use recall intervals of 1 week to 3 months, are subject to recall bias, and cannot measure pain variability. Methods The EAS enrolled a systematically‐recruited, community residing sample of adults, age 70+. Annual in‐person visits included neuropsychological and neurologic assessments, and recall‐based pain measures (Table 1). MCI was diagnosed using Jak‐Bondi criteria. Ecological Momentary Assessment (EMA) via smartphone was used to measure pain intensity and pain interference with activities and concentration 6 times per day for 14 days. We calculated mean daily pain (DP) intensity and mean DP interference as well as the standard deviations of these measures across days (i.e., variability). Logistic models were used to calculate odds ratios for associations between pain indices and MCI status, adjusting for age, sex and education. Results The study sample included 243 individuals (mean age 77.5, 65.4% females) including 68 with MCI and 175 normal controls (NC). On average, participants completed 84% of the daily EMA assessments (86% in NC, 78 % in MCI). There were no differences in the mean recall‐based pain measures between MCI and NC participants (Table1). Variability in DP intensity and interference with concentration were significantly higher in the MCI group compared to NC, while variability in DP interference with activities did not differ between groups (Table1). In logistic regression models, higher variability of DP intensity and DP interference with concentration was significantly associated with higher odds of having MCI status in logistic models (Table 2). Conclusion EMA‐based measures of variability in DP intensity and interference with concentration are associated at cross‐section with MCI while recall‐based pain measures are not. Future work will assess the predictive validity of pain intensity and interference for cognitive decline and incident MCI.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.045355
Institution: Albert Einstein College of Medicine
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3112968503