Exploring the Patterns of Chronic Pain Locations and Their Associations with All-Cause Dementia: Results from UK Biobank

Abstract

AbstractBackground: Chronic pain is a widespread and intricate condition that affects a substantial portion of the global population. Its impact poses both societal and economic threats, exerting physical and psychological strains and becoming a genuine long-term public health concern. Emerging evidence suggests an association between chronic pain and cognitive decline, particularly in the context of Alzheimer's disease, vascular dementia, and other dementia-like symptoms.While the conventional approach involves considering the count of locations and severity of pain in chronic pain research and clinical practice, this method may oversimplify the complexity of chronic pain experiences. Therefore, understanding the patterns of chronic pain locations and their associations with dementia is crucial for developing tailored and effective interventions as well as preventive strategies. This study aims to identify prevalent patterns of chronic pain locations and evaluate their associations with incident dementia among middle-aged and older adults in the UK Methods: This study leveraged medical data extracted from the UK Biobank, a large-scale prospective cohort study encompassing detailed health and genetic information from over 500,000 participants across the United Kingdom. The analysis involved a total of 445,530 participants, and incident dementia records were sourced from national health registers. Chronic pain location was self-reported, with respondents choosing from eight possible options: headache, face, neck or shoulder, back, stomach or abdominal, hip, knee, or all over the body.To identify the most prevalent patterns of chronic pain locations, the study calculated the incidence rates of all-cause dementia for the 20 most common combinations. Cox models were employed to examine the hazard of dementia for each of these 20 combinations in comparison to three groups: (i) participants without chronic pain, (ii) participants with only a single chronic pain location not included in the combination, and (iii) participants with only a single chronic pain location included in the combination.Results: The analysis unveiled that the size of the combinations of chronic pain locations varied, ranging from 6 to 8,207 persons. The three most prevalent combinations were neck and back (5.7%), back and knee (5.4%), and neck and knee (4.5%). Chronic pain in the back, neck, and knee was each present in over half of the 20 most prevalent combinations.Notably, chronic pain in the back, neck, and knee was commonly found either individually or simultaneously in combinations linked to higher dementia rates compared to individuals without chronic pain. Furthermore, combinations involving back, neck, and knee were associated with greater dementia rates than groups with a single pain location not included in the combination.Conclusions: The findings of this study strongly indicate that chronic pain is not randomly distributed across body locations and that specific patterns of chronic pain locations may be linked to an elevated risk of dementia. The understanding of how different patterns of chronic pain locations relate to dementia offers fresh insights into dementia prevention strategies through effective pain relief. These results emphasize the significance of acknowledging the complexity of chronic pain experiences and their potential implications for cognitive health.Further research is warranted to delve into the underlying mechanisms that connect chronic pain patterns to dementia. Additionally, exploring targeted interventions for dementia prevention through precise pain management would contribute to a more comprehensive understanding of the intricate relationship between chronic pain and cognitive health窗体底端Further research is warranted to delve into the underlying mechanisms that connect chronic pain patterns to dementia. Additionally, exploring targeted interventions for dementia prevention through precise pain management would contribute to a more comprehensive understanding of the intricate relationship between chronic pain and cognitive health