Summary: New study findings suggest that poorly managed chronic pain may increase dementia or Alzheimer’s risk in older adults. It appears that chronic pain may increase the level of certain brain chemicals, causing microglial activation and brain inflammation. Chronic pain patients may display increased beta-amyloid and tau proteins in cerebrospinal fluid.
One of the new studies shows that chronic pain can increase dementia risk. It may do so in multiple ways. There is some emerging evidence that older adults living with poorly managed chronic pain are at a greater risk of developing dementia.
To understand how these two diverse clinical conditions might be possibly associated, one needs to have a deeper understanding of both conditions.
Unlike acute pain, chronic pain may outlast the initial disease that caused it. Chronic pain may even occur due to no apparent reason. It may even occur for reasons generally not thought to cause prolonged pain, like mood and emotional disorders.
Similarly, dementia is also a complex multidimensional disorder. Dementia may occur for multiple reasons, from environmental toxins, genetic predisposal, inflammation, immune dysregulation, and more.
Of course, chronic pain is unlikely to be the prime cause of dementia, but it may be one of the factors. It may increase dementia risk, trigger dementia, or make dementia worse. At least, this is what one of the new studies suggests.
Chronic Pain Quite Likely to Increase Dementia Risk
Chronic pain may increase dementia risk in several ways, and it is detrimental to brain health. The new study published in the Annals of Neurology analyzed data from 995 dementia patients, with most of them diagnosed with Alzheimer’s. Looking at the patient history, researchers found that out of these patients, 61% have been suffering from chronic pain at baseline. It means that the majority of dementia patients had chronic pain before they were diagnosed with dementia.
This study also focused on possible underlying mechanisms. Thus, for example, chronic pain increases the levels of certain inflammatory chemicals in the brain. Chronic pain increases tumor necrosis factor-alpha levels known to activate microglia, thus causing brain inflammation. Hence, those with chronic pain are also more likely to have elevated levels of beta-amyloid and tau proteins in cerebrospinal fluid, a fluid that surrounds the spine. This indicates that chronic pain may ultimately increase dementia or Alzheimer’s risk, or it may act as a trigger.
From a clinical perspective, this study shows how important it is to treat chronic pain, especially in high-risk patients, that is, individuals with a greater risk of developing dementia. It also means that chronic pain may accelerate dementia progress, too.
Of course, the study has many limitations. It is more of a pilot study. It did not consider the association between pain severity and neural damage biomarkers. This means that the study did not investigate if more severe pain is associated with greater dementia risk or not.
Nevertheless, the study does show that chronic pain is quite likely one of the contributing or risk factors for dementia, especially in older adults.
The Bottom Line
Chronic pain disorder is quite common, occurring due to various reasons. Often, the cause of chronic pain is not fully understood. The same is true for dementia, as its prevalence is rising, and its cause remains poorly understood. Now,a new study shows that poorly managed chronic pain, especially in older adults, may trigger dementia or make dementia worse. This underlines the importance of effectively managing chronic pain in older adults.
Source:
Sadlon, A., Takousis, P., Ankli, B., Alexopoulos, P., Perneczky, R., & Alzheimer’s Disease Neuroimaging Initiative. (2023). Association of Chronic Pain with Biomarkers of Neurodegeneration, Microglial Activation, and Inflammation in Cerebrospinal Fluid and Impaired Cognitive Function. Annals of Neurology. https://doi.org/10.1002/ana.26804
