Chronic pain is associated with a brain aging biomarker in community-dwelling older adults :

Abstract

Chronic pain is associated with brain atrophy with limited evidence of its impact in the older adult’s brain. We aimed to determine the associations between chronic pain and a brain aging biomarker in persons 60 to 83 years old. Participants of the NEPAL study (n=47) completed demographic, psychological, and pain assessments followed by a QST battery and a T1-weighted MRI. We estimated a brain-predicted age difference that has been previously reported to predict overall mortality risk (brain-PAD; calculated as brain-predicted age minus chronological age), using an established machine-learning model. ANCOVAs and Pearson/Spearman correlations were used to determine associations of brain-PAD with pain, somatosensory and psychological function. Individuals with chronic pain (n=33) had “older” brains for their age compared to those without (n=14, F(1,41)=4.9, p=0.033). Greater average worst pain intensity was associated with an “older” brain (r=0.464, p=0.011). Among participants with chronic pain, those that reported having pain treatments during the past 3 months had “younger” brains compared to those that did not (F(1,27)=12.3, p=0.002). An “older” brain was significantly associated with decreased vibratory (r=0.323, p=0.033) and thermal (r=0.345, p=0.023) detection, deficient endogenous pain inhibition (F(1,25)=4.6, p=0.044), lower positive affect (r =−0.474, p=0.005), a less agreeable (r=−0.439, p=0.020), and less emotionally stable personality (r=−0.387, p=0.042). Our findings suggest that chronic pain is associated with added “age-like” brain atrophy in relatively healthy, community-dwelling older individuals and future studies are needed to determine the directionality of our findings. A brain aging biomarker may help identify people with chronic pain at greater risk of functional decline and poorer health outcomes.