Influence of chronic pain on cognitive performance in elderly caregivers: a longitudinal study

Terassi, Marielli; Montoya, Pedro; Pavarini, Sofia Cristina Iost; Hortense, Priscilla

doi:10.1590/0034-7167-2020-0412

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Revista Brasileira de Enfermagem

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (suppl 2) • 2021 • https://doi.org/10.1590/0034-7167-2020-0412 copy

Influence of chronic pain on cognitive performance in elderly caregivers: a longitudinal study

Influência da dor crônica no desempenho cognitivo em cuidadores idosos: estudo longitudinal

Influencia del dolor crónico en el desempeño cognitivo en cuidadores ancianos: un estudio longitudinal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to compare cognitive performance of elderly caregivers with and without chronic pain over four years and verify the effect of pain intensity on cognitive performance of elderly caregivers with chronic pain.

Method:

a longitudinal study with data collected in 2014 and 2018. Community-dwelling elderly caregivers of a Brazilian city participated in the study. Cognition was assessed using the Addenbrooke’s Cognitive Examination instrument. Pain was assessed by an 11-point scale. For data analysis, a mixed linear model and ANCOVA with a 5% significance level were used.

Results:

they were divided into two groups. A cognitive decline over four years was found in elderly people with pain (p=0.02; 95%CI=0.32-4.25), while those without pain did not show a significant change.

Conclusion:

the results show that elderly caregivers with pain had a worse cognitive performance, but when comparing groups with the ANCOVA test for intergroup analysis, there was no difference in cognitive performance.

Descriptors:
Elderly; Caregivers; Cognition; Chronic Pain; Public Health

Variables	Chronic pain (n=73)	Without pain (n=31)	Total (n=104)	p value
Sex
Female	83.6%	61,3%	76.9%	0.014
Male	16.4%	38.7%	23.1%	0.014
Age (mean, SD)	67.7 (±5.55)	69.7 (±6.06)	68.3 (±5.7)	0.995
Educational level (mean, SD)	3.0 (±2.7)	3.1 (±3.3)	3.0 (±2.9)	0.798
Number of medications (mean, SD)	3.6 (±2.3)	1.7 (±1.5)	3.0 (±2.2)	<0.001
Number of comorbidities (mean, SD)	6.0 (±3.2)	2.7(±1.8)	5.0 (±3.2)	<0.001
Care burden (continuous) (mean, SD)	20.9 (±16.0)	15.5(±11.6)	19.3 (±14.9)	0.096
Stress perceived (mean, SD)	21.8 (±10.8)	12.9 (±8.0)	19.5 (±10.6)	<0.001
Depressive symptoms
Presence	37%	3.3%	27.2%	<0.000
Absence	63%	96.7%	72.8%	<0.000
ACE-R domains (mean, SD)
Attention/orientation	13.5 (±2.37)	13.5(±3.04)	13.5 (±2.5)	0.954
Memory	14.6 (±5.79)	13.9 (± 6.4)	14.4(±5.9)	0.576
Language	18.3 (±4.82)	17.4 (±5.75	18.0 (±5.1)	0.328
Verbal fluency	5.7 (±2.93)	6.3 (±2.93)	5.9 (±2.8)	0.326
Visuospatial skills	10.3 (3.55)	9.4 (±3.61)	10.0 (±3.5)	0.614
Total score	62.6 (±16.06)	60.7 (±18.80)	62.0 (±16.8)	0.590

ACE-R domains	Chronic pain			Without pain
		n=73			n=31
	Estimate	CI 95%	p value	Estimate	95% CI	p value
Attention/orientation	0.32	-0.15 -0.78	0.18	0.47	-0.25 -0.19	0.19
Memory	1.79	0.75 - 2.84	<0.01	1.63	0.00- 3.27	0.05
Verbal fluency	-0.08	-0.60 - 0.43	0.75	0.93	0.13-1.73	0.02
Language	0.04	-0.66 - 0.75	0.91	0.37	-073-1.47	0.51
Visuospatial skills	0.22	-0.29 - 0.72	0.39	-037	-1.15-0.42	0.05
Total score	2.29	0.32 - 4.25	0.02	3.03	-0.03-6.10	0.05

Comparison^* * Differences between groups: without pain - with pain; model adjusted by sex, age, educational level, number of medications, number of comorbidities, hours of care, stress, and depressive symptoms.	Estimate	95% CI	P value
ACER-R	0.03	-4.23 - 4.30	0.99
Attention/orientation	-0.34	-1.33 - 0.65	0.49
Memory	-0.27	-2.59 - 2.05	0.82
Verbal fluency	0.63	-0.48 - 1.74	0.26
Language	0.59	-0.98 - 2.16	0.46
Visuospatial skills	-0.57	-1.72 -0.58	0.33

Effect	Estimate	95% CI	P value
ACE-R	0.03	-0.67 - 0.74	0.93
Attention/orientation	0.07	-0.10 - 0.23	0.44
Memory	-0.17	-0.56 - 0.22	0.38
Verbal fluency	0.10	-0.09 - 0.28	0.28
Language	0.11	-0.17 - 0.38	0.44
Visuospatial skills	-0.07	-0.24 - 0.11	0.46

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[1] Corresponding author: Marielli Terassi. E-mail: marielliterassi@gamil.com