title: Cognitive complaints in a general population of older adults: prevalence, association with pain and the influence of concurrent affective disorders.
abstract: Previous studies examining the associations between pain and cognitive complaints have been in pain clinic outpatients; there has been no research in the general population setting. A cross-sectional postal survey of 7878 older adults, aged 50 years and over, registered with three general practices (n=11230) in North Staffordshire using self-complete questionnaires was conducted. The questionnaire included the Alertness Behaviour Subscale from the Sickness Impact Profile to measure cognitive complaint, a full-body manikin to record presence and location of any recent pain (past 4 weeks) and the Hospital Anxiety and Depression Scale. The prevalence of any cognitive complaint was 46.5%; this increased with age (41.6% in 50-59 year olds to 63.4% in 80-100 year olds) and was higher in females than males (48.6% vs. 43.8%). Reporting recent pain was associated with a statistically significant increase in also reporting any cognitive complaint (odds ratio: 2.49; 95% confidence interval: 2.2, 2.8) and altered little after adjusting for age and gender. A dose-response relationship was seen when examining the association between pain and degree of cognitive complaint. Statistically significant associations between cognitive complaints and pain were seen across all anxiety and depression status. Cognitive complaints are common in a general population of older adults and are strongly related to the reporting of pain; a relationship which is independent of the presence of concurrent affective disorders. Taken together with previous work suggesting that subjective memory complaints are strongly correlated to risk of future cognitive decline, these results have implication for clinical practice in an aging population.
authors.affiliation: Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Keele, North Staffordshire, UK.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Westoby
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
authors.forename: Elaine
authors.initials: E
authors.lastname: Thomas
mesh_terms: D017677:Age Distribution; D000368:Aged; D000375:Aging / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology