Study: It’s not just chronic pain. It’s how many places it hurts that may affect the brain

BUFFALO, N.Y. – A new study by University at Buffalo researchers has provided valuable insights that clarify the relationship between chronic pain and cognitive function in middle-aged and older adults.

The findings published in the Journal of Gerontology: Psychological Sciences suggest that the presence of chronic pain itself does not predict poorer cognition, but pain experienced in more than one site is strongly associated with a faster decline later in life in areas such as memory, reasoning and attention tasks.

Multisite pain is common and can stem from conditions like fibromyalgia, lupus, hypothyroidism, or diabetes. But the number of pain sites matters regardless of diagnosis.

By spotlighting psychosocial pathways, beyond biological mechanisms, the work reframes how pain and aging are related and explains how multisite pain interferes with daily life and negatively affects social relationships, mood and well-being, according to Chang Yu, a doctoral candidate in the UB Department of Sociology and Criminology.

She says the right question in a clinical setting is a good starting point.

“Instead of asking patients ‘Do you have pain?’ clinicians should ask ‘How widespread is the pain?’” says Yu, the paper’s first author. “Nearly 40% of Americans living with chronic pain reported having pain in three or more body areas. That’s a large group who may be at higher risk for cognitive decline as they age.”

The study’s analysis used data from the 2004-2006 and 2013-2017 waves of the Midlife in the United States Study, a national sample tracking the age-related health variations of American adults aged 25-74.

The research team included Yu and UB associate professors of sociology and criminology Ashley Barr, PhD, and Hanna-Grol-Prokopczyk, PhD, and UB alumna Yulin Yang, PhD, a postdoctoral researcher at the University of California, San Francisco. The team examined the associations between pain status and the number of pain sites to measure how that pain interfered with activities, mood, relationships, sleep and enjoyment.

Cognitive and behavioral interventions, like social engagement, mood regulation and activity planning, can help reduce pain interference and may preserve cognitive health in mid- to late-life.

“Our findings encourage health systems and public health agencies to integrate multisite pain screening into aging and dementia-risk assessments,” says Yu. “Clinicians can then monitor where pain occurs and how it affects the factors contributing to an individual’s social life.”

Yu says future studies should investigate how the number and distribution of pain sites influence cognitive function over time.

“Continuing to pursue this line of research can help us understand how multisite pain influences not just cognition, but the rate of that cognitive decline,” she says.