Dementia, Alzheimer’s, And Stroke May Be Some Diseases Brought About By Chronic Pain

The Minded Institute

We’ve all experienced pain at some point in our lives, but once we get over than hump, we simply brush it off and thank the high heavens that we have medicines at our disposal. But then, there are those who have experienced chronic pain.

Studies have been conducted among patients who constantly suffer from pain. These researchers wanted to look into its long-term impact, especially when it comes to the health and wellbeing of an individual.


All about the Link

Patients who have suffered and experienced widespread pain had an increased incidence of all-cause dementia, Alzheimer’s disease, and stroke. What they also discovered is that this increased risk is not linked to other factors such as age, health, or sociodemographic circumstance. While this may seem unbelievable, researchers had actually analyzed data from a total of 2,464 participants of the Framingham Offspring Study Cohort. The patients in the study had undergone thorough examination by health practitioners between the years 1990 and 1994.

A study conducted by scholars at Chongqing Medical University in China is available online in the journal Regional Anesthesia & Pain Medicine. They discovered that patients who reported widespread pain had an increased incidence for future dementia and stroke. Researchers Dr. Kanran Wang and Dr. Hong Liu were the ones who found this increased risk, and as they looked further, they realize this to be independent of facets such as age, health, or other sociodemographic factors.

The World Health Organization’s (WHO) 11th revision of the International Statistical Classification of Diseases and Related Health Problems has defined widespread chronic pain as pain in at least four of the five body regions in humans. Widespread pain is also an authentic sign of fibromyalgia.

There were also earlier studies made, and these found that those who report experiencing widespread pain have an increased risk of a cardiovascular cause of death and an increased incidence of cancer as well as reduced a reduced survival for cancer. Still, the researchers believe this is the first study to use. They also need a detailed review of medical records and autopsies. There are other factors to consider when thinking of the link between widespread pain, dementia, and stroke.

Higher Risk for Dementia and Stroke

For the study made, the researchers from Chongqing Medical University gathered data from the Framingham Heart Study (FHS). For those unfamiliar with FHS, this is a large cohort study that began in 1948, with a total of 5,209 white men and women with the age range of 30 to 62 years old. These participants came from the town of Framingham, Massachusetts. Originally, the study’s goal was to fully and better understand heart disease.

Currently, the FHS is studying its third generation of participants. They have now encompassed more than 15,000 participants in total. As for the Chongqing Medical University researchers’ work, they looked at about 2,464 participants of the Framingham Offspring Study Cohort. The health practitioners then examined these participants between the years 1990 to 1994. Moreover, these participants underwent laboratory tests. They also were asked to fill out a questionnaire to determine if they have experienced pain or not. Out of all the participants, 347 reported experiencing widespread pain. 

The researchers found that these participants had the following:

  • Higher risk for all-cause dementia by 43 percent
  • Higher risk of Alzheimer’s disease by 47 percent
  • Higher risk of stroke by 29 percent

With the findings in hand, the researchers presented three hypotheses. These answered why the individuals experiencing widespread pain may have more risk when it comes to developing dementia or suffering from a stroke. The reasons behind it could be connected to lifestyle factors that have been associated with chronic pain. For instance, people who suffer from chronic pain might not up to par when asked to exercise regularly or to shop for food they need to head to the grocery and get items that get them to do a nutritious diet.

The researchers also have theorized that widespread pain could also directly compete for resources found in the brain that could help them with proper cognitive processing. The authors wrote, “The affective stress of [widespread pain] maybe, as other stressful exposures are, involved in quick cognitive decline via acknowledged cortisol-based pathways.”

Finally, the team came up with a hypothesis. They surmised that widespread pain could be a preclinical phase of all-cause dementia and Alzheimer’s disease. However, there is also a downside to it. The observational nature of the study itself prevents them from truly establishing the underlying mechanisms that work behind the increased risk. Hence, the authors advise that with the small numbers of stroke and dementia, the relationship may also likely be multifactorial. The authors also noted how study samples were homogeneously white. The findings made cannot be generalized, especially when it comes to including people from other races or ethnicities.


Linking Pain to Risk for Dementia and Stroke

Dr. Rebecca Edelmayer, senior director of scientific engagement for the Alzheimer’s Association spoke to Medical News Today in an interview. She called the Chongqing Medical University study “a very first step in trying to understand whether there’s any relationship” between pain and increased risk for developing all types of dementia and suffering from a stroke.

“I was actually excited to read this paper because I was hoping to see a really in-depth study looking at the different types of pain that might put people at more risk for dementia,” said Dr. Edelmayer. She completed her Ph.D. and postdoctoral training in medical pharmacology with a focus on neuropharmacology. She also said, “I think this paper brings up more questions actually than answers.”

Dr. Edelmayer also highlighted the fact that widespread pain is also a broad category. She spoke to MNT and explained,  “What causes pain is very different across the body. It could be cancer-induced pain, inflammatory pain — like arthritis, bone pain — like osteoarthritis, [and] neuropathic pain, which is sort of abnormal pain signaling and damaged nerves. There’s so many different reasons for people to be in pain.” Moreover, one type of pain may play more of a role in changing cognition than the other types, and according to the doctor, “I think much more research is still needed.”


The Real-World Implications of the Study

Dr. Vernon Williams, the founding director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA, spoke to MNT about the study. He has so much hope with the results of the Chongqing Medical University study. He believes that this will put a spotlight on the importance of pain treatment, especially a chronic one.

Dr. Williams shared, “What this is telling us is that, hopefully, as we improve pain management, we reduce the risk of people having cognitive dysfunction. We reduce the risk of people having strokes.”

A 2019 report was made and this found that 83 percent of primary care doctors believe it is difficult to treat patients who suffer from chronic pain. They said that there are risks involved with opioid intake and the wider opioid crisis. Dr. Williams has hopes for this new study. He believes that the findings will remind health practitioners about the significance and value of pain management.

Dr. Williams said in a statement, “I think it also helps reinforce to other stakeholders — and that can be physical therapists, insurers, patients, and family members — about how important it is to be aware of widespread pain and to manage it effectively because not only does it improve function and performance and quality of life right now, it may also have an effect on cognitive function down the line.”

As Dr. Vernon Williams put it, “We don’t want people to suffer in silence.”