Summary: One-fifth of the US population lives with chronic pain, and some live with high-impact chronic pain. A new study shows that poorly managed chronic pain is a leading cause of faster mental decline and memory loss. That raises Alzheimer’s risk. People with low income and status were most at risk, because of unequal health care. The study suggests these gaps may partly explain why Alzheimer’s is more common in Black Americans. So the study shows the need for equal access to chronic pain treatment for all groups.
Almost half of all adults may have long bouts of pain in their lifetime. Data suggest that 20% of people in the US live with chronic pain at any given time. These are huge numbers. Worse, 8% of adults have high-impact chronic pain. Most have to live with it because of poor pain care.
Chronic pain is distressing, to say the least. But in recent years, doctors have learned that chronic pain also raises the risk of many chronic health problems. For example, people with poorly managed chronic pain are more likely to develop high blood pressure, heart problems, depression, sleep disorders, and more. Now the new study suggests chronic pain may raise the risk of mental decline. This matters, given the rise of dementia. Dementia is now a top cause of early death and disability. It affects millions of lives.
The new study was published in the Journal of Alzheimer’s Disease. It gave detailed check-ups to 147 adults between the ages of 45 and 85. Researchers looked closely at life details and thinking tests, and used MRI brain scans. They found that pain raised dementia risk, mostly in people with less schooling, low income, and so poor access to health care. These people also had 4% less gray matter than those with more money and schooling. So the findings were not just based on how people felt. Hard data backed them up.
Of course, losing gray matter with age is common. Earlier studies show people slowly lose gray matter as they age. This usually begins in the 50s or 60s. The loss is usually about half a percent each year. So 3-4 percent equals 6 to 8 years. That means the brains of poor and deprived people age much faster. What is worrisome is that most people are diagnosed with conditions like Alzheimer’s in their 50s or later. This lower gray matter in deprived people suggests they face a higher risk of Alzheimer’s.
Researchers have also looked at how stress of many kinds may raise Alzheimer’s risk. For example, the risk of dementia is almost twice as high in Black Americans as in white Americans. But this study found that genes or ethnicity alone do not explain the gap. It seems unequal health care also plays an important part. These gaps lead to more pain and stress. That causes faster brain aging, memory problems, and a higher risk of Alzheimer’s in Black Americans than in white Americans.
The study also suggests a link between how bad the pain is and brain aging. The risk of faster brain aging seems to rise with pain intensity. That means people with poorly managed chronic pain are more likely to develop dementia. This is not the first study. An earlier study, done in 2017, had similar findings. It found that people older than 60 with chronic pain were more likely to see a sharp drop in thinking ability.
But there is some good news for people with poorly treated chronic pain. A study in 2009 found that treating chronic pain well may even reverse some of the changes in the brain. All these findings show how important it is to manage chronic pain and give enough relief.
Frequently asked questions
Can chronic pain cause memory loss?
Yes, when it is poorly managed. A study in the Journal of Alzheimer’s Disease checked 147 adults aged 45 to 85 with thinking tests and MRI brain scans. Chronic pain was linked to faster mental decline, memory loss and a higher risk of Alzheimer’s. A 2017 study found the same pattern. People over 60 with chronic pain saw sharper drops in thinking ability.
What happens to your brain when you have chronic pain?
It loses gray matter faster. Most people lose about half a percent of gray matter a year starting in their 50s or 60s. In this study, people in pain with low income or little schooling had about 4% less gray matter than better-off peers. That is roughly 6 to 8 extra years of brain aging. The stronger the pain, the faster the brain aged.
Does chronic pain increase the risk of dementia?
The study says it does. Pain raised dementia risk most in people with little schooling, low income and poor access to health care. Dementia is almost twice as common in Black Americans as in white Americans. The researchers found genes alone do not explain it. Unequal access to pain care means more pain and stress, and faster brain aging.
Can treating chronic pain reverse the brain changes?
Some of them. A 2009 study found that treating chronic pain well may reverse some of the changes it causes in the brain. Add the newer findings on gray matter and memory. Good pain control is about more than comfort. That is why managing chronic pain and giving enough relief matter so much.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
