Kumaradev, S;
Fayosse, A;
Dugravot, A;
Dumurgier, J;
Roux, C;
Kivimäki, M;
Singh-Manoux, A;
(2020)
Timeline of pain before dementia diagnosis: a 27-year follow-up study.
Pain
10.1097/j.pain.0000000000002080.
(In press).
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Abstract
This study examines the importance of length of follow-up on the association between pain and incident dementia. Further objective was to characterize pain trajectories in the 27 years preceding dementia diagnosis and compare them to those among persons free of dementia during the same period. Pain intensity and pain interference (averaged as total pain) were measured on 9 occasions (1991-2016) using the Short-Form 36 Questionnaire amongst 9046 (women=31.4%) dementia-free adults aged 40-64 years in 1991; 567 dementia cases were recorded between 1991-2019. Cox regression were used to assess the association between pain measures at different time points and incident dementia and mixed models to assess pain trajectories preceding dementia diagnosis or end point for dementia-free participants. Results from Cox regression showed moderate/severe compared to mild/no total pain, pain intensity, and pain interference not to be associated with dementia when the mean follow-up was 25.0, 19.6, 14.5, or 10.0 years. These associations were evident for a mean follow-up of 6.2 years: for total pain (hazard ratio=1.72; 95% confidence intervals=1.28-2.33), pain intensity (1.41; 1.04-1.92), and pain interference (1.80; 1.30-2.49). These associations were stronger when the mean follow-up for incidence of dementia was 3.2 years. 27-year pain trajectories differed between dementia cases and non-cases with small differences in total pain and pain interference evident 16 years before dementia diagnosis (difference in total pain score=1.4, 95% confidence intervals=0.1-2.7) and rapidly increasing closer to diagnosis. In conclusion, these findings suggest that pain is a correlate or prodromal symptom rather than a cause of dementia.
| Type: | Article |
|---|---|
| Title: | Timeline of pain before dementia diagnosis: a 27-year follow-up study |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/j.pain.0000000000002080 |
| Publisher version: | https://doi.org/10.1097/j.pain.0000000000002080 |
| Language: | English |
| Additional information: | This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial-No Derivatives License 4.0 (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
| Keywords: | pain, dementia, timeline, preclinical symptoms, cohort, prospective study |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10112238 |
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