Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
Department of Medical Statistics, Daegu Catholic University School of Medicine, Daegu, Korea.
Medicine (Baltimore). 2024 Oct 4;103(40):e39952. doi: 10.1097/MD.0000000000039952.
To elucidate the relationship between pain and cognitive decline in adults aged ≥60 years using data from the Korean Longitudinal Study of Aging survey. We included 3,287 older adults aged ≥60 years with a Korean Mini-Mental State Examination score ≥24. We assessed the presence of pain and pain interference using self-administered questionnaires. Pain interference was determined based on whether the pain limited the participants' activities of daily living. According to this assessment, participants were categorized as no pain, low-impact pain, and high-impact pain. Cognitive function was assessed using the Mini-Mental State Examination and classified into 3 groups: normal, cognitive impairment, and suspected dementia. Potential confounding factors, including pain × survey year, were adjusted in the analyses. We also performed subgroup analyses of participants experiencing pain to elucidate the association between pain interference, suspected dementia, and cognitive impairment. A significant difference in the Mini-Mental State Examination scores was observed between individuals with and without pain (P < .001). Pain remained negatively associated with the Mini-Mental State Examination score through the first to the eighth wave even after adjusting for confounding factors (β = -1.170, 95 % confidence interval (CI): -0.243, -0.097). Compared to the absence of pain, the presence of pain increased the odds of suspected dementia and cognitive impairment by approximately 1.6 and 1.4 times, respectively (odds ratio [OR] = 1.56, 95% CI: 1.26, 1.93; OR = 1.36, 95% CI: 1.20, 1.54). Compared to low-impact pain, high-impact pain increased the odds of suspected dementia and cognitive impairment by approximately 2.1and 1.5 times, respectively (OR = 2.12, 95% CI: 1.76, 2.56; OR = 1.47, 95% CI: 1.31, 1.65). Pain was negatively associated with Mini-Mental State Examination scores in Korean older adults aged ≥60 years and increased the odds of suspected dementia and cognitive impairment. Furthermore, individuals with high-impact pain exhibited higher risks of both suspected dementia and cognitive impairment than those with low-impact pain.
为了阐明≥60 岁成年人疼痛与认知能力下降之间的关系，我们利用韩国老龄化纵向研究的数据进行了研究。我们纳入了 3287 名≥60 岁且韩国简易精神状态检查评分≥24 的老年人。我们使用自我管理问卷评估了疼痛和疼痛干扰的存在。疼痛干扰根据疼痛是否限制参与者的日常生活活动来确定。根据这一评估，参与者被分为无疼痛、低影响疼痛和高影响疼痛。认知功能使用简易精神状态检查评估，并分为 3 组：正常、认知障碍和疑似痴呆。在分析中调整了潜在的混杂因素，包括疼痛×调查年份。我们还对有疼痛的参与者进行了亚组分析，以阐明疼痛干扰、疑似痴呆和认知障碍之间的关联。有疼痛和无疼痛的个体之间的简易精神状态检查评分有显著差异（P＜0.001）。即使在调整了混杂因素后，疼痛仍然与简易精神状态检查评分呈负相关，从第一波到第八波都如此（β=-1.170，95%置信区间：-0.243，-0.097）。与无疼痛相比，疼痛存在使疑似痴呆和认知障碍的几率分别增加了约 1.6 倍和 1.4 倍（优势比[OR]=1.56，95%置信区间：1.26，1.93；OR=1.36，95%置信区间：1.20，1.54）。与低影响疼痛相比，高影响疼痛使疑似痴呆和认知障碍的几率分别增加了约 2.1 倍和 1.5 倍（OR=2.12，95%置信区间：1.76，2.56；OR=1.47，95%置信区间：1.31，1.65）。疼痛与≥60 岁韩国老年人的简易精神状态检查评分呈负相关，并增加了疑似痴呆和认知障碍的几率。此外，高影响疼痛的个体发生疑似痴呆和认知障碍的风险高于低影响疼痛的个体。
