高冲击性疼痛预测主观认知衰退,并在客观认知障碍的发展中与APOE4基因型相互作用
Javier A Tamargo1, Glenn Smith2, Li Chen3
1Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.
The journal of pain
|September 18, 2025
概括
高冲击性慢性疼痛显著增加了老年人认知能力下降和痴呆症的风险. 针对疼痛的早期干预可能有助于预防未来的认知障碍,特别是那些没有APOE4基因的人.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 慢性疼痛是老年人中普遍存在的问题,通常与认知能力下降和痴呆症有关.
- 高冲击性疼痛,定义为限制日常活动的疼痛,需要进一步调查其认知后果.
研究的目的:
- 研究高冲击性疼痛与主观认知衰退 (SCD) 和客观认知障碍之间的关联.
- 确定高冲击性疼痛是否独立于SCD预测认知衰退,特别是与APOE4等位基因状态相关.
主要方法:
- 来自健康和退休研究 (2004-2020) 的50岁以上的13,763名成年人的数据分析.
- 高冲击性疼痛,SCD和客观认知障碍的评估.
- 统计建模包括调整的危险比率 (aHR) 和控制生物心理社会因素.
主要成果:
- 高冲击性疼痛与与没有或低冲击性疼痛相比,SCD的流行率和发病率显著更高.
- 高影响性疼痛预测客观认知障碍的风险增加,特别是在APOE4阴性个体 (aHR=1.21) 中.
- 在没有APOE4等位基因的普通人群中,高冲击性疼痛是未来认知障碍的更强有力的预测因素,而不是单独的SCD.
结论:
- 高冲击性疼痛是老年人主观和客观认知能力下降的重要预测因素.
- 通过早期干预来针对高影响性疼痛可能是一个可行的策略,以减少痴呆风险,特别是在APOE4阴性个体.
- 需要进一步的研究,以阐明关联疼痛和认知的机制,以便有效的治疗开发.
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