NeurologyPreventive Medicine

CHRONIC PAIN INCREASES DEMENTIA RISK

Researchers have reported that patients who have chronic pain have as much as a 36% greater chance of developing dementia later in life. Chronic pain is defined as pain that persists longer than 12 weeks despite medication or treatment. It is a major problem and pain management centers have become commonplace in today’s medical milieu. Pain specialists of various types (anesthesiologists, chiropractors, acupuncturists, etc.) have found their services in great demand. The correlation to dementia changes the way we look at chronic pain.

The importance of controlling, or relieving, chronic pain takes on greater significance when the dementia wrinkle is considered. I never would have connected dementia with chronic pain. The two just don’t seem to mix. But researchers from the United Kingdom studied more than 350,000 people between ages 39 to 73 to assess a correlation.

People who had chronic pain in only one location had a 15% higher risk of dementia than folks without pain. Those folks with chronic pain in more than one location had a 36% chance of dementia. Folks with chronic pain in multiple locations also had a faster rate of cognitive decline. The only reason mentioned for this was a decrease in the size of an area in the brain called the hippocampus. “Oh, really?” you say! Yes, the hippocampus. It’s a area on the floor of the brain that controls learning, emotion, short-term, and long-term memory. 

I still can’t correlate chronic pain, with the hippocampus, but neurologists feel the reduction in size clearly demonstrated by magnetic resonance imaging is clinically significant. Experts say the mechanism of this change remains unclear, but the correlation between chronic pain and increased risk for dementia coupled with the changes found on MRI imaging of the brain are enough to warrant further in depth study. 

Since there seem to be a lot of people with chronic pain, based on the proliferation of pain centers and the increased prescribing of analgesic pharmacotherapy, the potential for increased incidence of dementias is a likely concern. Or is this just a coincidence generated by overzealous researchers looking for something to write about and gain notoriety. Time will tell. 

References: Cao S, Fisher DW, Yu T, Dong H. The Link between Chronic Pain and Alzheimer’s Disease J Neuroinflammation 2019 Nov 6;16(1):204.

Medical News in Brief: Chronic Pain at Multiple Sites Tied to Increased Dementia Risk JAMA 2023 March 21;329(11):874-875.

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