Association of osteoarthritis and pain with Alzheimer's Diseases and Related Dementias among older adults in the United States

Abstract

Background: Emerging evidence suggests that Pain Interference (PI) and certain chronic pain conditions, including Osteoarthritis (OA) may be associated with risk for Alzheimer's disease and Related Dementias (ADRD). However, research exploring the relation of OA and PI to ADRD remains sparse. Objective: To assess the association of OA and PI to ADRD using cross-sectional data from a representative sample of USA adults aged 65 years. Design: Retrospective cross-sectional. Study sample: Older adults (age 65 years) drawn from the Medical Expenditure Panel Survey (MEPS, 2009e2015). Methods: OA was identified using both medical conditions files and participant responses to arthritisspecific queries. ADRD was ascertained using the medical conditions files. PI was defined as reported frequent PI with normal activities (PIA). OA and PIA were categorized as a composite variable: 1) OA with PIA; 2) OA without PIA; 3) No OA with PIA; and 4) No OA and no PIA (reference group). Adjusted associations of OA and PIA to ADRD were assessed using logistic regression and adjusted for biological, demographic, socioeconomic , lifestyle, and health conditions. Results: Overall, 27.1% had OA, of whom 47.6 % reported PIA vs 31.1% of those without OA; 2.8% had diagnosed ADRD. Adults with PIA either with or without OA had significantly higher odds of ADRD relative to those without OA or PIA (Adjusted odd ratios (AOR's) ¼ 1.37, 95%CI e 1.01, 1.86 (p ¼ 0.04) and 1.44, 95%CI e 1.13, 1.82 (p ¼ 0.003), respectively). Conclusion: PIA in both the presence and absence of OA remained significantly and positively associated with ADRD after adjustment for multiple confounders.

Non-Cancer Chronic Pain Conditions and Risk for Incident Alzheimer’s Disease and Related Dementias in Community-Dwelling Older Adults: A Population-Based Retrospective Cohort Study of United States Medicare Beneficiaries, 2001–2013

“…NCPC and increased ADRD risk; possible pathways: although the mechanisms underlying the observed association of NCPC to incident ADRD remain speculative, chronic pain may operate via several pathways to increase risk for dementia [21,23,[63][64][65]. Adults experiencing chronic pain have demonstrated diminished attention, impaired learning and memory, altered processing speed, reduced psychomotor efficiency, and compromised executive function [17][18][19]22,23], hallmarks of cognitive decline that may ultimately presage the development of cognitive impairment and dementia. Contributing to the documented decline in cognitive function that accompanies chronic pain, NCPC may promote specific adverse neurostructural and neurofunctional changes.…”

“…Specific mental health conditions (e.g., depression, anxiety) and chronic sleep impairment have also been shown to predict subsequent cognitive decline and conversion to ADRD [13][14][15][16]. In addition, there is growing evidence from observational and experimental research that chronic pain, an increasingly common and highly burdensome condition, may also contribute to elevated risk for neurocognitive impairment and development of ADRD [17][18][19][20][21][22][23].…”

Emerging Promise of Cannabinoids for the Management of Pain and Associated Neuropathological Alterations in Alzheimer’s Disease

“…In this study, it has been observed that higher levels of pain interference are directly connected with a higher possibility of developing dementia (Ezzati et al, 2019). In a study by Ikram et al (2019) also advocated that pain interference was considerably linked with AD and related dementia (ADRD). Furthermore, according to the study of Malfliet et al (2017) chronic pain and AD demonstrated aberrations of the volume of gray matter, and neuroimaging recommended that the patients of cognitive dysfunctions with chronic pain might be connected with alterations of the volume of gray matter in the brain.…”

“…In this study, it has been observed that higher levels of pain interference are directly connected with a higher possibility of developing dementia ( Ezzati et al., 2019 ). In a study by Ikram et al. (2019) also advocated that pain interference was considerably linked with AD and related dementia (ADRD).…”

The Role of Chronic Inflammatory Bone and Joint Disorders in the Pathogenesis and Progression of Alzheimer's Disease

“…In a study including 21,982 Appalachian adults aged 40 and older, participants with OA were found to be 80% more likely to report frequent memory loss independent of sleep or mood disorders (OR: 1.8, p < 0.001) (Innes and Sambamoorthi, 2018 ). Interestingly, in an investigation representing nearly 42.7 million Americans aged 65 or older, patient-reported pain, and the extent to which pain interfered with activities of daily living, was found to be significantly and positively correlated with the incidence of AD and related dementias, both in the presence (OR: 1.37) and absence (OR: 1.44) of OA ( p < 0.005) (Ikram et al, 2019 ). Further investigation is required to decouple the contributions of pain to disease pathology.…”