How Untreated Chronic Pain Can Increase Your Dementia Risk

February 23, 2023 / Thomas Cohn, MD

New research published this week found that untreated chronic pain can increase a person’s risk of cognitive decline and dementia, and that risk increases based on the number of areas in the body suffering from chronic pain.

The findings, published this week in the journal Proceedings of the National Academy of Sciences, found that chronic pain had an interesting effect on a person’s hippocampus, the area of the brain that is associated with learning and memory. Researchers compared the size of the hippocampus in patients with chronic pain to the size of the hippocampus in aging individuals without chronic pain. When comparing these models, researchers found that chronic pain may artificially age the hippocampus. When compared to a healthy 60-year-old patient, researchers found:

Patients with one chronic pain site had a hippocampus that had aged by an additional year.
Patients with two chronic pain sites had a hippocampus that had aged by roughly two additional years.
Patients with five or more chronic pain sites had a hippocampus that had aged by up to an additional eight years.

“In other words, the hippocampal (grey matter volume) in a 60-year-old individual with (chronic pain) at two body sites was similar to the volume of (pain free) controls aged 62-year-old,” wrote corresponding author Tu Yiheng and his colleagues.

So while you may only be 60 years old, if you are suffering from chronic pain in five or more locations in your body, your hippocampus may have experienced aging similar to that of a 68-year-old. Aging is a common underlying factor in dementia onset, and if your brain is artificially aged due to chronic pain, you may be more likely to experience dementia or cognitive decline.

Prevent Dementia By Treating Chronic Pain

While the findings may be a little concerning for patients dealing with chronic pain, fortunately we can try to reduce our dementia risk by really working to control and treat our chronic pain condition. This is certainly easier said than done, but if you develop a plan and work closely with a pain management specialist like Dr. Cohn, not only can you lead a more comfortable life free of chronic pain, but you can keep your brain healthy as you age.

Treating chronic pain is highly individualized, but may patients find that a combination of the following techniques can help them gain more control over their chronic pain condition:

Exercise
Posture Improvements
Dietary Changes
Physical Therapy
Stress Relief
Sleep Quality Improvements
Cognitive Behavioral Therapy
Deep Breathing Techniques

As you can see, all of the above techniques are active treatments that focus on improving one or more aspects of your health. Pain medications can certainly play a role in chronic pain management, but the above techniques are better at targeting the underlying pain cause and providing long-term relief.

Of course, working with a pain management specialist can help you find the right combination of treatments for your specific needs. If you want help identifying a pain treatment plan that’s right for you, or you just want to talk to a pain management provider about your symptoms, reach out to Dr. Cohn and his team today at (952) 738-4580.

Chronic Pain Linked To Dementia, Stroke and Alzheimer’s

August 26, 2021 / Thomas Cohn, MD

A new study published in Regional Anesthesia & Pain Medicine found that untreated widespread pain has been linked to an increased risk of other cognitive and cardiovascular disorders, like dementia, Alzheimer’s disease and stroke.

Widespread pain is a subtype of chronic pain that involves musculoskeletal disorders and related conditions. Previous studies have found an association between widespread pain and conditions like cancer, peripheral arterial disease and an increased death risk, but the latest study puts an even greater emphasis on the importance of working to successfully treat chronic pain.

Chronic Pain Research

For their study, researchers relied on data from 2,464 second-generation participants of the Framingham Heart Study. After an individual assessment, participants were grouped into three subsets:

Those with widespread pain (defined as pain above and below the waists or on both sides of the body).
Those with other pain (defined as pain in on or more joints).
No pain.

Lifestyle factors like BMI, employment status, depression scores, medication history, marital status, education level and other relevant health data were also collected, and then participants were continuously monitored for the beginning stages of cognitive decline, clinical dementia or their first stroke. During the monitoring period, 188 participants were diagnosed with dementia, and 139 people had a stroke.

After analyzing this data based on the previously created groups, researchers concluded that patients with widespread pain were 43 percent more likely to develop any type of dementia, 47 percent more likely to develop Alzheimer’s disease and 29 percent more likely to have a stroke than patients without widespread pain. When only looking at patients over the age of 65, those numbers changed to 39 percent, 48 percent and 54 percent respectively.

And while the study only found a correlation, not causation, researchers felt the findings were strong enough to conclude that “these findings provide convincing evidence that [widespread pain] may be a risk factor for all-cause dementia, [Alzheimer’s disease], and stroke.”

Simply put, if you are dealing with widespread or chronic pain, it’s imperative that you work with a pain management specialist or another professional to help treat the pain. You may think that it’s no big deal to just put up with annoying discomfort, but other areas of your health are in jeopardy if you don’t treat the problem head on. For more information, or for help diagnosing or treating your chronic pain, reach out to Dr. Cohn’s office today. We’re confident that we can find a solution to your chronic pain issue.

Does Chronic Pain Increase Likelihood Of Cognitive Decline?

June 6, 2017 / Thomas Cohn, MD

Recently, a new report published in the Journal of the American Medical Association suggests that there may be a link between chronic pain and the eventual onset of cognitive issues. But do these findings really suggest that chronic pain leads to an increased risk of cognitive decline, or is there something bigger going on? We take a closer look in today’s blog.

For their study, researchers at the University of California at San Francisco decided to look at how chronic pain impacted a person’s mental health. They began by examining data collected on more than 10,000 individuals over the age of 60 who were taking part in a different nationwide study. Patients in that study were surveyed about their pain scores and cognition in 1998 and 2000. Patients were then monitored over the next decade.

Chronic Pain and Brain Health

After looking at the data at the end of the study, researchers found that individuals who said they were persistently bothered by moderate or severe pain declined 9.2 percent faster in cognitive and memory tests over the next 10 years compared to those who said they were not in pain. Moreover, patients who complained about persistent pain exhibited a 7.7 percent greater chance of developing dementia than patients who did not experience regular pain.

“A persistent report of moderate to severe pain, which may reflect chronic pain, is associated with accelerated cognitive decline and increased dementia probability in a large population-representative data set of elders,” wrote first author Elizabeth Whitlock, MD, a postdoctoral fellow in the UCSF Department of Anesthesia and Perioperative Care. “Clinicians should be aware of this association, which persisted after extensive statistical adjustment for confounding health and demographic factors. Patients reporting ongoing pain may be at higher risk for current and incident cognitive impairment and physical debility.”

Pain Can Compound Mental Health Issues

The authors go on to make another key point about the problems associated with persistent pain and the onset of cognitive problems like dementia. Since individuals with pain oftentimes take opioids or other painkillers, cognitive decline can make it difficult for the patient to remember to take their pills or to get the correct dosage, which can be downright dangerous.

“Elderly people need to maintain their cognition to stay independent,” said Whitlock. “Up to one in three older people suffer from chronic pain, so understanding the relationship between pain and cognitive decline is an important first step toward finding ways to help this population.”

However, the study says the results don’t paint a perfect picture of the link between chronic pain and cognitive decline. Since a good deal of patients are on a variety of different pain medications to help control their pain, researchers said that the pills could be contributing to dementia and other cognitive problems, and pain may not play a role.

Hopefully future studies will look closer at the role opioids may play in cognitive decline. Regardless, this study is just more proof that we need to be investing more time and energy into seriously working to find solutions to the myriad of chronic pain problems in the US and throughout the world.