Age moderates the relationship between pain and cognition

Background and Aims: The relationship between pain and cognition is complex and not well-understood. In middle-aged chronic pain adults, higher clinical pain ratings have been associated with lower cognitive test performance. In contrast, in older chronic pain participants, higher clinical pain ratings have been associated with better cognitive test performance. This may indicate that age moderates the association between pain and cognition. The present study was intended to examine the effect of age on the relationship between pain and cognition.
Methods: Thirty-seven chronic pain participants of various ages (range 19–80) completed neuropsychological tests measuring speed, memory, executive function and sustained attention. They also gave clinical pain ratings. Finally, the cold pressure test (CPT) was used to evaluate experimental pain sensitivity.
Results: Age significantly moderated the relation of executive function with the CPT immersion time and the current pain intensity ratings. At a younger age, increased pain (higher current pain and shorter immersion time) was associated with lower executive function performance, whereas the relationship was reversed at an older age. Also, a higher score on the pain rating index of the McGill Pain Questionnaire was associated with lower memory performance at a younger age only.
Conclusions: This study is the first to show that age indeed moderates the relationship between pain and cognition, particularly with regard to executive function and memory. The finding that lower executive function is associated with less pain at an older age may point to diminished pain awareness associated with lower age-related executive function.