Associations Between Pain and Cognitive Impairment in Older Adults: Findings from the Birjand Longitudinal Aging Study

Background : Chronic pain is highly prevalent among older adults and has been shown to be associated with differences in cognitive function. While pain intensity reflects the severity of pain, pain interference assesses the extent to which pain disrupts daily activities. Distinguishing between these dimensions of pain and their associations with cognitive function may improve understanding of how pain relates to cognitive health in older populations. Methods : This cross-sectional study was conducted on baseline data from the Birjand Longitudinal Aging Study (BLAS). Pain was assessed using the Brief Pain Inventory (BPI), with average pain intensity measured by the BPI-5 score and pain interference by the BPI-9 score. Cognitive impairment was determined based on the combination results of the Six Item Cognitive Impairment Test (6-CIT), the Abbreviated Mental Test Score (AMTS), and the Category Fluency Test (CFT). Multiple logistic regression models were employed to examine associations between pain measures and cognitive impairment, adjusting for potential confounders. Results : Among 1,343 participants (mean age: 69.73 ± 7.53 years; 51.82% female), 59.64% were classified as cognitively impaired. In multivariable logistic regression analyses, higher pain interference (BPI-9) was significantly associated with cognitive impairment (OR = 1.01, 95% CI: 1.00–1.03, p = 0.002). Whereas, pain intensity (BPI-5) showed no significant association with cognitive impairment (OR = 1.00, 95% CI: 0.94–1.06, p = 0.019). Conclusion : This study underscores the significant association between pain interference and cognitive impairment in older adults. These findings highlight the importance of addressing pain's impact on daily functioning to mitigate cognitive decline in this population.