September 13, 2021
Widespread pain, a common type of chronic pain that can affect many areas of the body, is tied to an increased risk of Alzheimer’s disease, according to a new report. The findings underscore the importance of pain as a potential factor in cognitive health.
For the study, researchers at The First Affiliated Hospital of Chongqing Medical University in China analyzed records from 2,464 men and women who were part of the large and ongoing Framingham Heart Offspring Study. Participants were given comprehensive medical workups that included physical exams, laboratory test and detailed pain assessments.
About 14 percent suffered from widespread pain, which can include conditions like fibromyalgia. The American College of Rheumatology defines widespread pain as chronic pain, persisting at least three months, that affects a mix of 54 points around the body: above and below the waist, on both sides of the body, and pain in the skull, back or ribs. Widespread pain is different than chronic pain that may affect only one area of the body, such as lower back pain, an arthritic knee, plantar fasciitis of the foot, or shoulder pain.
The researchers found that compared to those with more localized chronic pain or no pain, those with widespread pain were 47 percent more likely to develop Alzheimer’s disease. They were also at higher risk of developing other forms of dementia, as well as stroke. The study did not address whether effective pain management might mitigate the effects of chronic pain on brain health.
The researchers considered other factors that may increase the risk of Alzheimer’s disease, including high blood pressure, diabetes, obesity, smoking, high alcohol consumption, depression, years of schooling and how much exercise participants got. Body-wide chronic pain was independently tied to an increased risk of Alzheimer’s disease and other forms of dementia. The findings were published in Regional Anesthesia and Pain Medicine.
The study shows only an association and cannot prove cause and effect. But earlier studies have shown that chronic pain is tied to an increased risk of cancer, vascular disease and dying young. A large study from 2017 found that persistent pain was likewise tied to an increased risk of dementia. In that study, older men and women who reported chronic pain had more rapid declines in memory tests over a 12-year period.
Previous research has also shown that people with chronic pain are more likely to be obese, to eat a poor diet and to get limited amounts of exercise, factors that can increase the risk of both heart disease and dementia. Chronic pain may also lead to decreased brain volume, a risk factor for dementia. Chronic pain is often associated with a higher level of inflammation, and that is clearly a contributing factor for brain deterioration.
Chronic pain is also a common problem in people with Alzheimer’s disease, who may not be able to communicate their problems effectively. Effective treatment for chronic pain is challenging, but pain specialists are available to aid with treatment. Anyone with chronic pain who is concerned about cognitive loss, or who is caring for a loved one with chronic pain, should talk to their doctor.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Kanran Yang, Hong Liu: “Association between widespread pain and dementia, Alzheimer’s disease and stroke: a cohort study from the Framingham Heart Study.” Regional Anesthesia and Pain Medicine, August 16, 2021