title: Chronic widespread pain is associated with slower cognitive processing speed in middle-aged and older European men.
abstract: Evidence from clinic-based studies suggests that the fibromyalgia syndrome (FMS) is associated with impairment in cognitive function though the mechanism is unclear. The aim of this analysis was to determine whether there is a similar association between chronic widespread pain (CWP), a cardinal feature of FMS, and impaired cognition in a community setting. Men (n=3369, 40-79 years) were recruited from population registers in eight centres for participation in the European Male Ageing Study (EMAS). The subjects completed a pain questionnaire and pain manikin, with the presence of CWP defined using the American College of Rheumatology criteria. The cognitive functions measured were visuospatial-constructional ability and visual memory (Rey-Osterrieth Complex Figure [ROCF]); visual recognition (Camden Topographical Recognition Memory test [CTRM]); and psychomotor processing speed (Digit-Symbol Substitution test [DSST]). We restricted our analysis to those subjects reporting pain that satisfied the criteria for CWP and those who were pain free. Of these 1539 men [mean (SD) age 60 (11) years], 266 had CWP. All cognitive test scores declined cross-sectionally with age (P<0.05). In age-adjusted linear regressions men with CWP had a lower DSST score (β=-2.4, P<0.001) compared to pain-free subjects. After adjustment for lifestyle and health factors the association between pain status and the DSST score was attenuated but remained significant (β=-1.02, P=0.04). There was no association between CWP and the ROCF-copy, ROCF-recall or CTRM scores. CWP is associated with slower psychomotor processing speed among community-dwelling European men. Prospective studies are required to confirm this observation and explore possible mechanisms for the association.
authors.affiliation: Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK School of Community Based Medicine, The University of Manchester, Salford Royal NHS Trust, Salford, UK Institute of Psychological Sciences, University of Leeds, Leeds, UK Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary Division of Gerontology and Geriatrics & Centre for Musculoskeletal Research, Department of Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS); CIBER de Fisiopatología Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III;Santiago de Compostela, Spain Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy Reproductive Medicine Centre, Malmö University Hospital, University of Lund, Sweden Department of Endocrinology, Royal Free and University College Hospital Medical School, Royal Free Hospital, Hampstead, London, UK Department of Reproductive Biology, Imperial College London, Hammersmith Campus, London, UK Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland Department of Human Nutrition, University of Glasgow, Glasgow, UK Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium Andrology Research Unit, Department of Medicine, The University of Manchester, Manchester Academic and Health Sciences Centre, Manchester Royal Infirmary, Manchester, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Lee
authors.forename: N
authors.initials: N
authors.lastname: Pendleton
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authors.initials: A
authors.lastname: Tajar
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authors.initials: TW
authors.lastname: O'Neill
authors.forename: D B
authors.initials: DB
authors.lastname: O'Connor
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authors.initials: G
authors.lastname: Bartfai
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authors.initials: FF
authors.lastname: Casanueva
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authors.initials: JD
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authors.initials: AJ
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authors.forename: D
authors.initials: D
authors.lastname: Vanderschueren
authors.forename: C M
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authors.initials: FCW
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mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D002908:Chronic Disease; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology*; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007858:Learning / Q000502:physiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D010775:Photic Stimulation / Q000379:methods; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time; D012016:Reference Values; D012111:Residence Characteristics; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014796:Visual Perception / Q000502:physiology; D044465:White People