399: Association Between Chronic Musculoskeletal Pain and Cognitive Impairment

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Pharmacological treatments, Assessment and Measurement of Pain/Nociception, Treatment/management

Background and Aims: Chronic musculoskeletal pain is common in older adults and a major cause of disability. Although emerging evidence suggests links between chronic pain and cognitive ageing or dementia, epidemiological findings remain inconsistent and are often confounded by heterogeneous pain phenotypes and outcome definitions, limiting its integration into clinical risk assessment.

Methods: We performed a PRISMA-compliant systematic review and meta-analysis of observational studies that examined associations between chronic musculoskeletal pain and cognitive impairment, mild cognitive impairment, or dementia. PubMed, Embase, and the Cochrane Library were searched through July 2025. Random-effects models were used to pool relative risks (RRs) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed to explore heterogeneity across pain definitions, cognitive outcomes, and geographic regions.

Results: Twenty-four cohort, case-control, and cross-sectional studies involving 1,067,898 participants met inclusion criteria. Chronic musculoskeletal pain was associated with higher risk of cognitive impairment or dementia (pooled RR=1.38; 95% CI, 1.18-1.60). Associations were observed in cohort (RR=1.30, 95% CI, 1.11-1.51) and cross-sectional studies (RR=1.61, 95% CI, 1.03-2.51) and remained robust in sensitivity analyses. Stronger associations occurred in studies using pain severity scales and self-reported cognitive complaints, suggesting relevance to early, potentially detectable cognitive changes. No substantial publication bias was detected.

Conclusions: Chronic musculoskeletal pain is consistently associated with increased risk of late-life cognitive impairment and dementia. These findings underscore its clinical relevance as a potential risk marker for cognitive decline and support integrating pain assessment with cognitive screening and multidomain preventive strategies in ageing populations.

References: [1] Patel, M., Hasoon, J., Diez Tafur, R., Lo Bianco, G., Abd-Elsayed, A., 2025. The Impact of Chronic Pain on Cognitive Function. Brain sciences. 15.
[2] Whitlock, E.L., Diaz-Ramirez, L.G., Glymour, M.M., Boscardin, W.J., Covinsky, K.E., Smith, A.K., 2017. Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders. JAMA internal medicine. 177, 1146-1153.
[3] Bornier, N., Mulliez, A., Chenaf, C., Elyn, A., Teixeira, S., Authier, N., Bertin, C., Kerckhove, N., 2023. Chronic pain is a risk factor for incident Alzheimer's disease: a nationwide propensity-matched cohort using administrative data. Frontiers in aging neuroscience. 15, 1193108.

Presenting Author: Ming-Xuan Yang
Submitting Author: Ming-Xuan Yang

Senior Author: Yun Wang

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Yun Wang: Doctor - Peking University
• Si-Qi Jia: Doctor - Peking University
• Hong-Lai Cao: None - Peking University
• Huan Zhang: master - Haleon China R&D
• Jiang-Qiong Zhao: Doctor - Haleon China R&D
• Chun-Yu Lu: Master - Haleon China R&D
• Jin-Bin Zhang: Doctor - Haleon China R&D