Summary: Dementia and stroke are challenging to predict. Alzheimer’s is the leading cause of dementia, and yet it remains a poorly understood condition. Researchers know that Alzheimer’s starts years or perhaps even decades before its diagnosis. They also know that early risk identification may also help prevent its progress. However, at present, there are no known early tests or biomarkers. However, the new study found that chronic widespread pain has a significant association with the ten-year risk of dementia/Alzheimer’s and stroke.
Predicting the risk of Alzheimer’s or other-cause dementia remains elusive as ever. At present, there are no reliable tests to predict the risk. Many researchers believe that Alzheimer’s starts years or even decades before its diagnosis. However, the lack of its early biomarkers/tests means that precious time is lost. Many medications, lifestyle interventions might be pretty helpful if initiated early.
Experts understand that there is a need to create a simple toolbox to help identify Alzheimer’s early enough. It would be great if such a toolbox did not use any expensive laboratory tests.
The rise of Alzheimer’s in the last few decades also suggests that it might be considered a lifestyle disease. Genetics is a risk factor, and environmental factors could be regarded as triggering factors.
The new study shows that chronic widespread pains (CWP) are associated with a greater risk of dementia and stroke.
CWP is a pain that lasts for more than three months, affects various parts of the body. There are other symptoms associated with it like chronic fatigue, lack of concentration, psychological issues. It is one of the significant signs of fibromyalgia1.
In the new study, researchers used the data from Framingham Heart Study (FHS)2. One might wonder what heart study has to do with dementia or Alzheimer’s. However, there is a connection. Firstly, these studies collect extensive health relative data over a prolonged period. Secondly, the data is collected related to all cardiovascular and metabolic disorders, not only heart health. Finally, there is an association between heart health and the risk of dementia and stroke. Thus, analyzing this data makes perfect sense.
In the FHS study, the pain status of individuals was assessed between 190-1994. And the study followed up for dementia incidence for an average of 10 years, with insights potentially valuable for chronic pain specialists.
During the data analysis, researchers found that 347 (14.1%) had CWP, and 2117 (85.9%) did not have CWP. Out of these 347 people with widespread chronic pain, 188 ultimately developed all-cause dementia. Among them, 128 were tested to be positive for Alzheimer’s3.
The study found that CWP was associated with a 43% greater risk of all-cause dementia, 47% higher risk of Alzheimer’s, and 29% higher risk of stroke. All these findings are significant. Moreover, the study leaves no doubt that widespread chronic pains might be one of the excellent predictors of dementia or stroke later in life3.
Using such findings may help create a toolbox that may help predict the risk of Alzheimer’s, all-cause dementia, or stroke quite accurately. However, the accuracy of such a toolbox can be considerably improved by adding other signs and symptoms to the toolbox, like the association of sleep disorders, psychological issues with dementia, and stroke.
However, there are certain limitations to these findings. Experience shows that diagnosing CWP early enough is quite challenging. Most people living with CWP would consult physicians irregularly complaining about one or another localized pain. Thus, physicians are pretty likely to miss the diagnosis of CWP.
Nonetheless, the study has some significance. It shows that there is a possibility of developing a simple toolbox for accessing the risk of dementia or stroke later in life. Moreover, such a toolbox can be readily used even in resource-scarce settings. Although, using such a toolbox may require additional training and specific skills1.
References
- Mansfield KE, Sim J, Croft P, Jordan KP. Identifying patients with chronic widespread pain in primary care. Pain. 2017;158(1):110-119. doi:10.1097/j.pain.0000000000000733
- Framingham Heart Study. Accessed November 23, 2021. https://framinghamheartstudy.org/
- Wang K, Liu H. Association between widespread pain and dementia, Alzheimer’s disease and stroke: a cohort study from the Framingham Heart Study. Reg Anesth Pain Med. 2021;46(10):879-885. doi:10.1136/rapm-2021-102733
