Abstract
Chronic pain is associated with worse mental health and cognitive impairment, which can be a cause or a consequence of brain structure and function alterations, e.g., maladaptive plasticity, antinociceptive system dysregulation. Cognitive reserve reflects the effectiveness of the internal connections of the brain and it has been shown to be a protective factor in brain damage, slowing cognitive aging or reducing the risk of mental health disorders. The current study explored the impact of chronic pain on psychosocial factors, mental health, and cognition. Furthermore, we aimed to examine the role of cognitive reserve in the relationship between mental health and chronic pain clinical characteristics in middle-aged adults. The study group consisted of 477 volunteers from the Barcelona Brain Health Initiative who completed online surveys on pain, mental health, cognitive reserve, and psychosocial factors (sleep and quality of life). We described the differences in sociodemographic data, psychosocial factors, mental health, and self-perceived cognitive impairment, and neuropsychological assessment, between participants reporting pain compared with those without pain, as well as the main characteristics of the chronic pain group. Finally, to study the role of cognitive reserve in the modulation of the relationship between chronic pain and mental health, we compared variables between subgroups of participants with high/low pain intensity and cognitive reserve. The results showed that chronic pain was reported by 45.5% of middle-aged adults. Our results revealed that participants with chronic pain were older and had worse health status than people without pain. The presence of chronic pain affected working memory, mental health, and daily life activities. Moreover, cognitive reserve moderated the influence of pain intensity on mental health, resulting in less mental health affection in people suffering from high pain intensity with high cognitive reserve. In conclusion, the construct of the cognitive reserve could explain differential susceptibility between chronic pain and its mental health association and be a powerful tool in chronic pain assessment and treatment, principally due to its modifiable nature.
Highlights
The aims of the current study were: (1) to investigate the presence of chronic pain (CP), its clinical characteristics, and their impact on measured and self-perceived cognition and general psychological aspects, (2) to explore its putative interference with specific psychological aspects related with mental health (MH), and (3) to examine the hypothesized Cognitive Reserve (CR) protective role, expected to weaken the relation between pain and MH in a healthy middleaged sample
The current study explored the impact of CP on psychosocial factors, MH, and cognition
We aimed to examine the role of CR in the relationship between MH and CP clinical characteristics in middle-aged adults
Summary
A pain persisting beyond 3 months, has been linked with altered mood and mental health disorders (Baliki and Apkarian, 2015; Baker et al, 2016; Kawai et al, 2017), cognitive impairments (refer to Moriarty et al, 2011 for a review), sleep disturbances (Karaman et al, 2014; Generaal et al, 2017), and decreased quality of life (Leadley et al, 2014; Kawai et al, 2017; Senba and Kami, 2017) These factors can influence the experience of pain and help the transition from acute to chronic pain (CP) (Apkarian et al, 2013). A complete model for understanding pain must include risk factors, which have been widely studied and protective ones In this regard, Cognitive Reserve (CR) could potentially play a role. Low CR estimates decreased quality of life, increased anxiety and depression, and increased risk for drug dependence and medication overuse (Gómez-Beldarrain et al, 2015)
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