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疼痛与蒙特利尔认知评估(MoCA)在老龄化中的应用。

Pain and the Montreal Cognitive Assessment (MoCA) in Aging.

机构信息

Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.

Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida.

出版信息

Pain Med. 2021 Aug 6;22(8):1776-1783. doi: 10.1093/pm/pnab003.


DOI:10.1093/pm/pnab003
PMID:33718961
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8346915/
Abstract

OBJECTIVE: The present study aimed to determine whether specific cognitive domains part of the Montreal Cognitive Assessment (MoCA) are significantly lower in community-dwelling older adults with chronic pain compared with older adults without pain and whether these domains would be associated with self-reported pain, disability, and somatosensory function. DESIGN: Secondary data analysis, cross-sectional. SETTING: University of Florida. SUBJECTS: Individuals over 60 years old enrolled in the Neuromodulatory Examination of Pain and mobility Across the Lifespan (NEPAL) study were included if they completed the MoCA and other study measures (n = 62). Most participants reported pain on most days during the past three months (63%). METHODS: Subjects underwent a health assessment (HAS) and a quantitative sensory testing (QST) session. Health/medical history, cognitive function and self-reported pain measures were administered during the HAS. Mechanical and thermal detection, and thermal pain thresholds were assessed during the QST session. RESULTS: Older adults with chronic pain had lower MoCA scores compared with controls on domains of executive function, attention, memory, and language (P < 0.05). The attention and language domains survived adjustments for age, sex, education, depression, and pain duration (P < 0.05). Attention was significantly associated with all pain characteristics including pain intensity and disability, while executive function was associated with mechanical detection (P < 0.05). CONCLUSION: Our results support previous findings that individuals with chronic pain tend to show poorer cognitive functioning compared with pain-free controls in domains of attention and executive function. Our findings also extend these findings to community-dwelling older adults, who are already most vulnerable to age-related cognitive declines.

摘要

目的:本研究旨在确定与无疼痛的老年人相比,患有慢性疼痛的社区居住老年人是否存在蒙特利尔认知评估(MoCA)特定认知域显著降低,以及这些域是否与自我报告的疼痛、残疾和躯体感觉功能相关。

设计:二次数据分析,横断面研究。

地点:佛罗里达大学。

受试者:参加跨生命周期疼痛和移动性的神经调节检查(NEPAL)研究的年龄在 60 岁以上的个体,如果他们完成了 MoCA 和其他研究测量(n=62),则包括在内。大多数参与者报告在过去三个月中的大多数日子里都有疼痛(63%)。

方法:受试者接受健康评估(HAS)和定量感觉测试(QST)。HAS 期间进行了健康/医学史、认知功能和自我报告疼痛测量。在 QST 期间评估了机械和热探测以及热痛阈值。

结果:与对照组相比,患有慢性疼痛的老年人在执行功能、注意力、记忆和语言等领域的 MoCA 评分较低(P<0.05)。在调整年龄、性别、教育、抑郁和疼痛持续时间后,注意力和语言领域仍然存在(P<0.05)。注意力与所有疼痛特征显着相关,包括疼痛强度和残疾,而执行功能与机械探测相关(P<0.05)。

结论:我们的研究结果支持先前的研究结果,即与无疼痛的对照组相比,患有慢性疼痛的个体在注意力和执行功能等领域往往表现出较差的认知功能。我们的研究结果还将这些发现扩展到社区居住的老年人,他们已经最容易受到与年龄相关的认知能力下降的影响。

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Front Pain Res (Lausanne). 2024-12-16

[3]
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Curr Geriatr Rep. 2023-12

[4]
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[5]
Greater socioenvironmental risk factors and higher chronic pain stage are associated with thinner bilateral temporal lobes.

Brain Behav. 2023-12

[6]
Postoperative serum CHI3L1 level is associated with postoperative cognitive dysfunction in elderly patients after hip fracture surgery: A prospective observational study.

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[7]
The Relationship Between Chronic Pain and Cognitive Impairment in the Elderly: A Review of Current Evidence.

J Pain Res. 2023-7-7

[8]
Self-reported pain and fatigue are associated with physical and cognitive function in middle to older-aged adults.

Geriatr Nurs. 2023

[9]
Predictors of the Health-Related Quality of Life (HRQOL) in SF-36 in Knee Osteoarthritis Patients: A Multimodal Model With Moderators and Mediators.

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[10]
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本文引用的文献

[1]
Age and pain differences in non-verbal fluency performance: Associations with cortical thickness and subcortical volumes.

Exp Gerontol. 2019-8-21

[2]
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Mol Pain. 2019

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Chronic pain is associated with a brain aging biomarker in community-dwelling older adults.

Pain. 2019-5

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Normative data for the Montreal Cognitive Assessment (MoCA) and the Memory Index Score (MoCA-MIS) in Brazil: Adjusting the nonlinear effects of education with fractional polynomials.

Int J Geriatr Psychiatry. 2018-2-12

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The MoCA-Memory Index Score: An Efficient Alternative to Paragraph Recall for the Detection of Amnestic Mild Cognitive Impairment.

Alzheimer Dis Assoc Disord. 2018

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Pain. 2018-2

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Clin J Pain. 2018-3

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Cognitive deficits in chronic pain patients, in a brief screening test, are independent of comorbidities and medication use.

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Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity.

Phys Ther. 2016-7

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J Pain. 2014-10-29

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