Summary: A new study found that chronic widespread pain is significantly linked to the ten-year risk of dementia/Alzheimer’s and stroke. Dementia and stroke are hard to predict. Alzheimer’s is the top cause of dementia, yet it is still poorly understood. Researchers know Alzheimer’s starts years or maybe even decades before it is diagnosed. They also know that spotting risk early may help slow it. But right now, there are no known early tests or biomarkers.
Predicting the risk of Alzheimer’s or other dementia is as hard as ever. Right now, there are no reliable tests to predict it. Many researchers believe Alzheimer’s starts years or even decades before diagnosis. But without early tests, precious time is lost. Many medicines and lifestyle changes might help a lot if started early.
Experts know we need a simple toolbox to spot Alzheimer’s early. It would be best if it did not need any costly lab tests.
The rise of Alzheimer’s in the last few decades suggests it may be a lifestyle disease. Genes set the risk, and the environment may pull the trigger.
The new study shows that chronic widespread pain (CWP) is linked to a higher risk of dementia and stroke.
CWP is pain that lasts more than three months and affects many parts of the body. It comes with other symptoms like chronic fatigue, poor focus, and mental strain. It is one of the main signs of fibromyalgia1.
In the new study, researchers used data from the Framingham Heart Study (FHS)2. You might wonder what a heart study has to do with dementia or Alzheimer’s. But there is a link. First, these studies collect lots of health data over a long time. Second, they collect data on all heart, blood vessel and metabolic disorders, not just heart health. Finally, heart health is tied to the risk of dementia and stroke. So studying this data makes perfect sense.
In the FHS study, people’s pain status was checked between 190-1994. The study then tracked new cases of dementia for an average of 10 years, with insights that may be useful for chronic pain specialists.
In the data, 347 people (14.1%) had CWP, and 2117 (85.9%) did not. Of these 347 people with widespread chronic pain, 188 went on to develop dementia of any cause. Of them, 128 tested positive for Alzheimer’s3.
The study found that CWP was linked to a 43% higher risk of dementia from any cause, a 47% higher risk of Alzheimer’s, and a 29% higher risk of stroke. All these findings are significant. The study leaves no doubt that widespread chronic pain may be one of the best early signs of dementia or stroke later in life3.
These findings may help build a toolbox that predicts the risk of Alzheimer’s, dementia, or stroke quite well. And the toolbox could get much better by adding other signs. Sleep disorders and mental health problems are also tied to dementia and stroke.
But these findings have limits. Experience shows that CWP is hard to diagnose early. Most people with CWP see doctors now and then, each time about one local pain. So doctors are quite likely to miss the diagnosis of CWP.
Still, the study matters. It shows we may be able to build a simple toolbox to check the risk of dementia or stroke later in life. Such a toolbox could even be used where resources are scarce. But using it may take extra training and special skills1.
Frequently asked questions
Does chronic pain increase the risk of dementia?
Chronic widespread pain does. One analysis used Framingham Heart Study data. People with chronic widespread pain had a 43% higher risk of dementia from any cause. They had a 47% higher risk of Alzheimer’s disease and a 29% higher risk of stroke over about ten years. That makes widespread pain one of the strongest early warning signs we have.
What is chronic widespread pain?
Chronic widespread pain is pain that lasts more than three months and affects several parts of the body. It usually comes with chronic fatigue, trouble focusing and mental strain. It is one of the main signs of fibromyalgia.
Is there a test that predicts Alzheimer’s early?
Not yet. Alzheimer’s starts years or even decades before diagnosis. But there are no reliable early tests or biomarkers, so precious time is lost. Researchers want a simple toolbox that needs no costly lab work. It would use signs such as chronic widespread pain, sleep disorders and mental health symptoms. It would flag risk while medicines and lifestyle changes can still help.
Why is chronic widespread pain often missed?
Because it rarely shows up as one complaint. Most people with chronic widespread pain see doctors now and then, each time about a single local pain. Seen one piece at a time, the overall pattern is easy to miss. So is the early warning it carries for dementia and stroke.
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
Dr. Gurpreet Singh Padda, MD, MBA, MHP
