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Pain differences in cognitive impairment appear only during active motor tasks.
Stefan Lautenbacher1, Vivien Schreiber2, Clemens Grupp3
1Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany.
Frontiers in Pain Research (Lausanne, Switzerland)
|July 13, 2026
Summary
Cognitive impairment in older adults is linked to increased movement-related pain during daily activities. This suggests that reduced cognitive function impacts how pain is experienced during physical tasks.
Area of Science:
- Gerontology
- Neuroscience
- Pain Research
Background:
- Cognitive impairment in older adults is inconsistently associated with altered pain processing and increased pain vulnerability.
- The impact of cognitive status on pain perception, particularly movement-related pain in real-world contexts, requires further investigation.
Purpose of the Study:
- To investigate the hypothesis that cognitive impairment more significantly affects movement-related pain in everyday contexts compared to pain sensitivity in laboratory settings.
- To compare pain experiences during motor tasks and experimental pain assessments between cognitively healthy and cognitively impaired older adults.
Main Methods:
- Utilized the CERAD scale (Consortium to Establish a Registry for Alzheimer's Disease) to classify 76 older adults (38 cognitively healthy, 38 cognitively impaired) into groups matched for age and sex.
- Assessed pain intensity (NRS) during standardized motor tasks (walking, bed mobility, lifting) and experimental pressure/heat pain sensitivity.
- Collected data on perceived exertion during motor tasks and clinical pain status via structured interviews.
Main Results:
- No significant differences were found between groups in baseline clinical pain or experimental pain sensitivity.
- Cognitively impaired participants reported significantly higher movement-related pain during the motor tasks.
- Cognitive status (CERAD classification) explained significant additional variance in movement-related pain, beyond clinical pain and experimental pain sensitivity.
Conclusions:
- Reduced cognitive functioning is a significant predictor of increased pain during active, everyday motor tasks in older adults.
- This association may stem from diminished capacities for pain-minimizing movement strategies, including recall, planning, and execution.
- Findings highlight the importance of assessing pain within behaviorally relevant contexts to understand pain mechanisms in older adults with cognitive impairment.
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