Older adults exhibiting symptoms of depression coupled with moderate to severe joint pain are likely to experience an accelerated decline in cognitive functions, particularly memory. This finding emerges from a study supported by FAPESP and published in the journal Aging & Mental Health, which draws on data from 4,718 participants aged 50 and above, tracked over 12 years. The research team includes experts from the Federal University of São Carlos (UFSCar) in Brazil and University College London (UCL) in the UK.
The study suggests that pain and depressive symptoms impact brain regions, notably the hippocampus, which are crucial for cognitive processes. This dual burden potentially leads to a ‘clogging’ of cognitive functions, forcing the brain to redistribute tasks to manage both pain and depressive symptoms, adversely affecting memory formation and overall cognitive performance. According to Patrícia Silva Tofani, a researcher in the Gerontology Program at UFSCar and a professor at the Federal University of Sergipe, this cognitive overload progressively leads to a swifter decline in cognitive abilities over time.
The study’s participants are part of the English Longitudinal Study of Ageing (ELSA Study), which forms a component of the International Collaboration of Longitudinal Studies of Ageing (InterCoLAgeing), a global consortium headed by Tiago da Silva Alexandre, a professor in UFSCar’s Department of Gerontology. Tofani conducted this research during her postdoctoral studies, focusing on the correlation between memory decline and the co-occurrence of chronic pain and depressive symptoms.
Analysis from the study indicates that individuals suffering concurrently from pain and depression exhibited a more rapid deterioration in both memory and overall cognitive function over the 12-year follow-up compared to those with neither condition. Interestingly, those experiencing only one of these issues did not face an accelerated decline, which was an unexpected discovery. Alexandre noted that while they anticipated a more significant cognitive decline in individuals with both depressive symptoms and chronic joint pain compared to those with only one of these conditions, the compounded impact of both was notably more detrimental than anticipated.
The study identifies six cognitive domains affected: executive function, language, attention, memory, perceptomotor functions, and social cognition. Despite observing a decline in global cognition and memory, the researchers did not detect a decrease in executive function, which Tofani highlights as crucial for maintaining independence in elderly individuals, allowing them to manage daily living tasks effectively.
Both depressive symptoms and joint pain are prevalent among older adults, often underreported, and commonly misattributed to normal ageing processes. This misattribution can lead to inadequate assessment and management in primary care settings, emphasizing the need for greater awareness and targeted care for these conditions. Chronic joint pain is typically linked to conditions like osteoarthritis, which is prevalent among older adults.
The study’s findings underscore the critical need for primary care practitioners to better recognize and address depressive symptoms and joint pain in older adults. Overlooking these conditions can adversely affect not only the mood and physical mobility of the elderly but also their cognitive functions. Alexandre stresses the importance of not dismissing these symptoms as mere effects of ageing, as doing so can prevent the identification and treatment of conditions that, while familiar, are modifiable with appropriate medical intervention.
More information: Patrícia Silva Tofani et al, Does the coexistence of pain and depressive symptoms accelerate cognitive decline? Aging & Mental Health. DOI: 10.1080/13607863.2024.2392737
Journal information: Aging & Mental Health Provided by Fundação de Amparo à Pesquisa do Estado de São Paulo
