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Cognitive Decline and Dementia in Chronic Widespread Pain: A Longitudinal Population-based Study
Xue Jiang1, Elin Johansson2, Jo Nijs3
1Rehabilitation Medicine Center, Second Affiliated Hospital of Wenzhou Medical University, Zhejiang, China; School of Rehabilitation Medicine, Wenzhou Medical University, Zhejiang, China; School of Exercise and Health, Shanghai University of Sport, Shanghai, China; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
Anesthesiology
|August 25, 2025
Summary
Chronic widespread pain (CWP) is linked to increased risks of cognitive impairment and dementia. Alterations in brain structure and systemic inflammation may explain this connection.
Area of Science:
- Neuroscience
- Public Health
- Gerontology
Background:
- Chronic widespread pain (CWP) is prevalent but its impact on cognition and underlying mechanisms are not fully understood.
- Preliminary research suggests a link between chronic pain and cognitive decline, necessitating further investigation into CWP's specific effects.
- Understanding the neurobiological underpinnings of CWP's influence on cognitive health is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate the association between chronic widespread pain (CWP) and the risk of dementia and mild cognitive impairment.
- To explore the potential mediating roles of brain structure and systemic inflammation in the relationship between CWP and cognitive performance.
- To analyze cognitive performance using a comprehensive battery of tests in individuals with and without CWP.
Main Methods:
- Population-based cohort study using UK Biobank data from 188,594 participants with 13 years of follow-up.
- Chronic widespread pain (CWP) defined by self-report of pain all over the body for ≥3 months.
- Cognitive function assessed via eight tests; dementia and mild cognitive impairment identified through inpatient records; systemic inflammation markers analyzed from blood samples.
Main Results:
- Individuals with chronic widespread pain (CWP) showed a significantly elevated risk of mild cognitive impairment (HR [95%CI]: 2.55[1.31 - 4.97]) and dementia (1.53 [1.13 - 2.0]).
- No causal association was detected between CWP and dementia (β = 1.50, PAdjusted = 0.076).
- Brain structural volumes (e.g., thalamus, insular cortex) and systemic inflammatory markers (e.g., lymphocytes, platelets) may mediate the CWP-cognitive performance link, though cautious interpretation is advised due to timing imprecision.
Conclusions:
- Chronic widespread pain (CWP) is significantly associated with increased risks of cognitive impairment and dementia.
- Alterations in brain structure and systemic inflammation appear to mediate the relationship between CWP and cognitive decline.
- These findings highlight the importance of addressing CWP in the context of cognitive health and dementia prevention.
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