Chronic pain is a risk factor for incident Alzheimer's disease: a nationwide propensity-matched cohort using administrative data

Nadège Bornier; Aurélien Mulliez; Chouki Chenaf; Antoine Elyn; Sarah Teixeira; Nicolas Authier; Célian Bertin; Nicolas Kerckhove

doi:10.3389/fnagi.2023.1193108

Chronic pain is a risk factor for incident Alzheimer's disease: a nationwide propensity-matched cohort using administrative data

Front Aging Neurosci. 2023 Sep 28:15:1193108. doi: 10.3389/fnagi.2023.1193108. eCollection 2023.

Authors

Nadège Bornier¹, Aurélien Mulliez¹, Chouki Chenaf^{1

2}, Antoine Elyn³, Sarah Teixeira¹, Nicolas Authier^{1

2}, Célian Bertin^{1

2}, Nicolas Kerckhove^{1

2}

Affiliations

¹ Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de L'Innovation, Université Clermont Auvergne, Clermont-Ferrand, France.
² Institut Analgesia, Clermont-Ferrand, France.
³ Centre D'Évaluation et de Traitement de la Douleur, Service de Neurochirurgie, Pôle Neuroscience, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.

Abstract

Introduction: Chronic pain (CP) is one of the most disabling conditions in the elderly and seems to be a risk factor for the development of Alzheimer's disease and related dementias (ADRD). Only one study, using national administrative health databases, assessed and demonstrated that chronic pain (all types of pain) was a risk factor for dementia, but without assessing the impact of pain medications.

Method: To assess the impact of all types of chronic pain and the long-term use of pain medications on the person-years incidence of ADRD, a retrospective nationwide healthcare administrative data study was performed using the national inter-regime health insurance information system (SNIIRAM) to the French national health data system (SNDS). Incident people >50 years old with chronic pain, defined by at least 6-months duration analgesics treatment or by a diagnosis/long-term illness of chronic pain between 2006 and 2010, were included. Chronic pain individuals were matched with non-CP individuals by a propensity score. Individuals were followed up from 9 to 13 years to identify occurrences of ADRD from 2006.

Results: Among 64,496 French individuals, the incidence of ADRD was higher in the chronic pain population than control (1.13% vs. 0.95%, p <0.001). Chronic pain increases the risk of ADRD (HR = 1.23) and the incidence of ADRD was higher for women and increased significantly with age.

Discussion: Our study highlights the importance of prevention, diagnosis, and management of chronic pain in elderly to reduce the risk of development and/or worsening of dementia.

Keywords: Alzheimer disease; dementia; epidemiology–analytic (risk factors); incidence; pain.