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Does Chronic Pain Increase Dementia Risk?

Does Chronic Pain Increase Dementia Risk?

Chronic pain is a growing problem and affects half of older adults who live on their own and up to 85% of those in care facilities [1]. A recent study published in JAMA Internal Medicine reported that people with chronic pain had a more rapid memory decline and a faster increase in dementia probability compared to those without it [2].

These findings come from a large, long-term study of 10,065 people over age 62. Researchers asked questions about pain and cognition every other year from 1998 through 2012. Participants who reported that they often had moderate or severe pain in both 1998 and 2000 were considered to have chronic pain. After adjusting for many variables, people with chronic pain had on average a 9.2% faster memory decline and a 7.7% faster increase in dementia probability. Over the next decade, those with chronic pain were more likely to be unable to manage their finances or their medications, two important tasks for independent living.

Chronic pain can impact cognitive function in several ways. It increases levels of stress hormones, which can impact brain structures involved in cognitive health [3]. Chronic pain can also divert attention, making it more difficult to perform cognitive and memory tasks [4]. And chronic pain can interfere with good quality sleep, which is important for optimal cognitive function [5].

Though the study was well-done, it wasn't designed to prove cause and effect. It did not distinguish the source of the pain (e.g., arthritis, back pain, cancer-related pain) or the type of treatment used by the participants (e.g., NSAIDs such as aspirin versus opioids). Therefore, it remains unclear whether the pain itself impacts cognitive function or whether the source of the pain or if and how it is treated matters more. Still, if you have chronic pain and notice issues with memory or other cognitive functions, talk to your doctor about getting assessed for cognitive decline. There are options to manage or alleviate chronic pain, such as assistive devices, physical or occupational therapy, or mindfulness strategies.

It is worth pointing out that the association between chronic pain and dementia is significantly smaller than the association between dementia and other conditions such as diabetes. For example, diabetics can have up to a 73% increased risk of dementia and a 2-fold higher risk of developing vascular dementia compared to non-diabetics [6-9]. Also, there is encouraging evidence suggesting that following these First Steps may help reduce your risk for cognitive decline or dementia.


  1. (2011) Seniors and chronic pain. NIH MedlinePlus.
  2. Whitlock EL, Diaz-Ramirez LG, Glymour MM et al. (2017) Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders. JAMA Intern Med.
  3. Lupien SJ, McEwen BS, Gunnar MR et al. (2009) Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci 10, 434-445.
  4. Dick BD, Rashiq S (2007) Disruption of attention and working memory traces in individuals with chronic pain. Anesth Analg 104, 1223-1229, tables of contents.
  5. Lo JC, Groeger JA, Cheng GH et al. (2016) Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Med 17, 87-98.
  6. Chatterjee S, Peters SA, Woodward M et al. (2016) Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia. Diabetes Care 39, 300-307.
  7. Deckers K, van Boxtel MP, Schiepers OJ et al. (2015) Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry 30, 234-246.
  8. Gudala K, Bansal D, Schifano F et al. (2013) Diabetes mellitus and risk of dementia: A meta-analysis of prospective observational studies. J Diabetes Investing 4, 640-650.
  9. Vagelatos NT, Eslick GD (2013) Type 2 diabetes as a risk factor for Alzheimer's disease: the confounders, interactions, and neuropathology associated with this relationship. Epidemiol Rev 35, 152-160.

Yuko Hara, PhD, is Director of Aging and Alzheimer's Prevention at the Alzheimer's Drug Discovery Foundation. Dr. Hara was previously an Assistant Professor in Neuroscience at the Icahn School of Medicine at Mount Sinai, where she remains an adjunct faculty member. Her research focused on brain aging, specifically how estrogens and reproductive aging influence the aging brain's synapses and mitochondria. She earned a doctorate in neurology and neuroscience at Weill Graduate School of Medical Sciences of Cornell University and a bachelor's degree in biology from Cornell University, with additional study at Keio University in Japan. Dr. Hara has authored numerous peer-reviewed publications, including articles in PNAS and Journal of Neuroscience.

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