慢性疼痛和认知障碍风险:对纵向队列研究的元分析
Di Qiu1, Zhang-Bing Zhou1, Xin-Yu Li1
1Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
Translational psychiatry
|March 6, 2026
概括
慢性疼痛增加了认知能力下降的风险,特别是痴呆症. 这项对700多万人的元分析证实了持续性疼痛与认知障碍之间的联系,特别是在老年人中.
科学领域:
- 神经科学是一个神经科学.
- 流行病学 流行病学
- 老年学是一门学科.
背景情况:
- 慢性疼痛是与认知衰退相关的日益关注的问题.
- 现有的观察性研究显示,关于这种关联的发现不一致.
- 了解慢性疼痛对认知的长期影响对于公共卫生至关重要.
研究的目的:
- 进行元分析,评估慢性疼痛与认知障碍之间的长期关联.
- 确定与慢性疼痛相关的特定类型的认知衰退.
- 探索可能调节这种关系的因素.
主要方法:
- 在PubMed,Embase和Cochrane图书馆进行系统的文献搜索,截至2025年1月.
- 包括28项纵向队列研究,涉及7,914,407名参与者.
- 使用随机效应模型汇集调整的赔率比率;子组,灵敏度和元回归分析.
主要成果:
- 慢性疼痛与30%更高的认知障碍风险相关 (OR=1.30).
- 这种关联是由痴呆症风险增加 (OR=1.43) 而不是全球认知表现 (OR=0.99) 驱动的.
- 在随访时间较长 (≥5年),老年人群和头痛相关疼痛的研究中观察到更强烈的关联.
结论:
- 慢性疼痛与痴呆症风险增加有关,特别是在老年人中.
- 抑郁症显著缓解了慢性疼痛和认知障碍之间的关联.
- 建议采用针对疼痛和抑郁症的综合临床策略,并进行进一步的机制研究.
相关概念视频
Long-term Depression
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over time, all...
Calcium Ion Concentration Mechanism
If over time, all...
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function. They...
Longitudinal Studies
Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
Cognitive Development During Adulthood
Cognitive development continues throughout adulthood, undergoing significant shifts across early, middle, and late stages. Individual transition occurs from adolescent idealism to pragmatic and adaptable thinking in early adulthood. During this period, individuals learn to integrate personal beliefs with the recognition that other perspectives are equally valid. Exposure to the complexities of modern society, diverse experiences, and higher education contribute to this adaptive thought process,...
Stress and Mental Health
Chronic stress profoundly affects mental health, significantly influencing mood, behavior, and overall quality of life. Research closely links chronic stress with mental health conditions such as depression, anxiety, and substance use disorders. Ongoing exposure to stress can lead to physiological and psychological changes, initiating a cycle of emotional distress and maladaptive coping mechanisms.
Individuals with depression often experience challenges in both their personal and professional...
Individuals with depression often experience challenges in both their personal and professional...
Alzheimer Disease l: Introduction
Alzheimer disease is a chronic, progressive, and irreversible neurodegenerative disorder and the most common cause of dementia in older adults. It leads to gradual neuronal loss, causing cognitive decline, behavioral changes, and loss of functional independence.Risk Factors and EtiologyThe disease is multifactorial. Age is the strongest risk factor, with prevalence doubling every 5 years after age 65. Genetic factors include mutations in genes such as APP, PSEN1, and PSEN2, which are associated...


