On the interplay between chronic pain and age with regard to neurocognitive integrity: Two interacting conditions?

Abstract

In this article, the interrelatedness of age and chronic pain is discussed and testable hypotheses about this interrelationship are postulated. Numerous studies have consistently shown mild cognitive problems, together with changes in brain gray and white matter integrity, in chronic pain patients. More recently, a handful of studies have indicated that age may play a crucial role in the reduced neurocognitive integrity in these chronic pain patients. However, studies systematically examining this interrelationship are lacking. We now give several propositions of this interaction between age and chronic pain by summarizing the evidence for the following testable hypotheses: 1) neurocognitive deficits in chronic pain are age-dependent, 2) chronic pain induces early aging, or 3) chronic pain can be considered as an age accelerator, resulting in a disproportional decline in neurocognitive integrity with increasing age. To advance this important field, it is highly recommended that future studies systematically document cognitive and neuroanatomical changes in chronic pain patients as a function of age.

Keywords: Age accelerator; Attention; Chronic pain; Cingulate cortex; Cognitive compensation; Early aging; Executive function; Gray matter; Memory; Prefrontal cortex; Speed; White matter.