Widespread Pain may Inflate the Risk of Dementia and Stroke

The risk of dementia (including Alzheimer’s disease) and stroke is found to be elevated with widespread pain as per a study published online in the journal Regional Anesthesia & Pain Medicine.

The connection between both the conditions was found to be independent of potentially influential factors, such as age, general health, and lifestyle.

What is Dementia?

Dementia is an umbrella term for a group of neurodegenerative diseases that are characterized by gradual memory loss, cognitive decline, and behavioral changes.

Depending upon the types of pathology, there are several types of dementia, one of the most common ones being – Alzheimer’s disease (AD). Alzheimer's disease is characterized by the formation of tau tangles and beta-amyloid plaques in the brain tissues, years before the actual symptoms occur.

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What is Stroke?

Stroke is defined as a sudden restriction of blood flow to the brain that affects its function. Certain types of stroke can even result in devastating or long-term disability to the patients.

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Stroke is basically of two types:

• Ischemic Stroke (due to occlusion of the blood vessels)
• Hemorrhagic Stroke (due to bursting of the blood vessels)

The Link between Pain and other Ailments

Any unpleasant physical sensation may be defined as pain. It is usually caused by some illness or injury and its severity is a highly subjective perception. If the pain lasts longer than six months, it is called chronic pain.

This type of chronic pain continues even after the injury or illness ceases. This occurs because the pain signals remain active in the nervous system for weeks, months, or years. In certain cases, this pain may also occur with no pre-existing injury or body damage.

Underlying conditions that may be linked to chronic pain include:

• Musculoskeletal disorders
• Cancer
• Peripheral arterial disease
• Cardiovascular disease
• Heightened risk of death

What’s New to the List?

Although it is established that widespread pain may be an early indicator of several diseases, a recent study has also found its association with cognitive decline like dementia and also stroke.

The study team evaluated data from 2464 second-generation participants of the US long-term, multigenerational, community-based Framingham Heart Study, known as the Offspring Study.

The participants underwent a comprehensive check-up – physical exam, lab tests, and detailed pain assessments between 1990 and 1994. Depending upon their pain assessment, they were further divided into the following pain groups:

• Widespread pain – defined according to American College of Rheumatology criteria as pain above and below the waist, on both sides of the body, the skull, backbone, and ribs (347 people; 14%).
• Other pain – classified as pain in one or more joint(s) only or no pain in any joints (2117 people in total).

Study Design

Researchers also evaluated the data on potentially influential factors such as evidence of high blood pressure, diabetes, weight (BMI), lifestyle (smoking, drinking, diet, and physicalactivity levels), employment status, depression scores, history of pain medication, income, marital status, and educational attainment.

Changes in the cognitive decline of the participants were then monitored throughout along with evidence on clinical dementia (average of 10 years) or a first stroke (average of 15 years).

Pain, Dementia & Stroke - The Loop!

It was noticed that 188 people had a clinical diagnosis of dementia, among which 50 (27%) had widespread pain and 138 (73%) did not have the pain during the monitoring period.

Among the occurrence of stroke in 139 people, 31 (22%) had widespread pain and 108 (78%) did not have the pain.

The participants were then sifted for other influential factors. Data reported a 43% higher chance of getting any type of dementia, 47% higher chance of Alzheimer’s disease, and 29% chance of acquiring stroke, among the people with widespread pain compared to those without it.

The Difference among the Aged Ones

The comparable risk among those above the age of 65 years revealed

• 39% heightened risk of all types of dementia
• 48% heightened risk of Alzheimer’s disease
• 54% heightened risk of stroke

“These findings provide convincing evidence that [widespread pain] may be a risk factor for all-cause dementia, [Alzheimer’s disease], and stroke. This increased risk is independent of age, sex, multiple sociodemographic factors, and health status and behaviours,”say the authors.

Study Limitations

Since this was an observational study, authenticating the exact cause behind this relationship was not feasible. However, the widespread pain may affect the cognitive function directly as part of the prodromal phase of dementia and Alzheimer’s disease.

The authors also presume that the relationship between pain and cognitive decline is anticipated to be multifactorial as the substantive numbers of dementia and stroke cases were low. Further larger studies are thereby obligated to explore other likelihoods.

Stats on Dementia & Stroke

• Approximately 50 million dementia cases exist globally with 10 million new cases diagnosed annually.
• Alzheimer's disease makes up 50% to 70% of dementia cases, and 25% is contributed by vascular dementia.
• Stroke is a leading cause of long-term disability especially among seniors globally.
• Every 40 seconds someone has a stroke and every 4 minutes, someone dies of a stroke in the United States.
• Ischemic strokes contribute to about 87% of all strokes.
• Stroke-related expenses cost nearly $46 billion in the United States between 2014 and 2015.
• Sustaining a healthy lifestyle with routine exercise and mental activity helps prevent brain degeneration

Quick Facts on Pain

• Pain is both a physical and emotional uneasiness to the body.
• Although severe pain may cause worry, pain is found to worsen with increased levels of stress.
• It is found that women feel more pain than men.
• One of the most common types of pain conditions is back pain.
• It was reported that more than 26 million Americans between the ages of 20 to 64 years suffer from back pain.
• Smoking may elevate your risk for back pain.
• The brain is responsible for transmitting pain signals to the body; However, did you know that your brain doesn't feel any pain?
• It is advisable to take lots of rest during pain, but complete bed rest may worsen any type of chronic pain.
• Some animals don't feel the pain such as naked mole rats and lobsters.

References:

1. Association between widespread pain and dementia, Alzheimer’s disease and stroke: a cohort study from the Framingham Heart Study - (https://rapm.bmj.com/content/early/2021/08/02/rapm-2021-102733)
2. Acute vs. Chronic Pain - (https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain)
3. Vascular Dementia - (https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia)
4. Dementia Risk Factors - (https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/dementia/risk-factors.html)
5. Stroke Facts - (https://www.cdc.gov/stroke/facts.htm)

Source-Medindia