Department of Sociology, Texas State University, San Marcos, TX, USA.
School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA.
Aging Clin Exp Res. 2020 Dec;32(12):2611-2620. doi: 10.1007/s40520-020-01491-6. Epub 2020 Feb 13.
Chronic pain and cognitive decline are common age-related conditions affecting a large segment of older populations. Little is known about the pathway of cognitive functioning during the course of pain management in older adults.
The study aimed to examine the association between chronic body pain management and cognitive function over time among Chinese older adults.
A total of 792 respondents aged 60 and above from urban and rural households in 28 provinces, 150 counties/districts, and 450 communities were selected from the China Health and Retirement Longitudinal Study (2013-2015). Cognitive function was measured in three domains: episodic memory, mental status, and global cognitive function. Difference-in-differences approach and mixed-effects linear regression models were employed to assess the association between chronic body pain management and cognitive function over time.
Scores of mental status were found to decline slower by 0.49 unit (SE = 0.22, p < 0.05) in respondents who received pain management using analgesics, complementary and alternative medicine, or both from 2013 to 2015 after controlling for basic demographic and health confounders.
Chronic pain management was associated with slower decline in domain-specific cognitive function, mental status over time. Findings of the study may contribute to understanding the mechanism of change in diverse cognitive abilities attributable to pain symptoms. More research is needed to elucidate the mediating effect of pain on cognitive decline, which could lead to testing of the impact of pain management on cognitive function among older population in both clinical and community settings.
慢性疼痛和认知能力下降是常见的与年龄相关的疾病，影响着很大一部分老年人群。关于老年人在疼痛管理过程中认知功能的变化途径，目前知之甚少。
本研究旨在探讨中国老年人慢性躯体疼痛管理与认知功能随时间变化的关系。
本研究从中国健康与退休纵向研究（2013-2015 年）中选取了来自全国 28 个省、150 个县/区和 450 个社区的 792 名年龄在 60 岁及以上的城乡居民作为研究对象。认知功能在三个领域进行了测量：情景记忆、精神状态和总体认知功能。采用差分法和混合效应线性回归模型评估了慢性躯体疼痛管理与认知功能随时间变化的关系。
在控制了基本人口统计学和健康混杂因素后，研究发现，从 2013 年到 2015 年，接受镇痛药、补充和替代医学或两者联合治疗的患者，其精神状态评分下降速度较慢，下降幅度为 0.49 个单位（SE=0.22，p<0.05）。
慢性疼痛管理与特定领域认知功能的下降、精神状态随时间的下降有关。本研究的结果可能有助于理解由于疼痛症状导致的不同认知能力变化的机制。需要进一步的研究来阐明疼痛对认知能力下降的中介作用，这可能会导致在临床和社区环境中测试疼痛管理对老年人群认知功能的影响。
