Objective: The purpose of this study was to explore the reciprocal relationship between pain severity and executive function in community-dwelling older adults. Method: In this prospective cohort study, 64 Japanese community-dwelling older adults aged 60 years or older (mean age 72.8 years; women, 68.8%) were analyzed. Pain severity was assessed by self-reported questionnaire while executive function was assessed by the Trail Making Test at baseline and at 1-year follow-up assessment. A mixed effect model was conducted to analyze the effect of baseline executive function on change in pain severity and effect of baseline pain severity on change in executive function. Results: The effect of baseline Trail Making Test on change in pain severity was not significant. On the contrary, the effect of high baseline pain severity on the decline in set shifting (Trail Making Test Part B) was significant even after adjustment with age, sex, years of education, depressive symptoms, and analgesic drug use. Conclusion: Higher baseline pain severity was associated with greater executive function decline in community-dwelling older adults. Executive function decline due to severe pain should be considered as well as pain itself.
Keywords: community-dwelling older adults; executive function; pain severity; set shifting.