Does the presence of chronic pain affect scores on cognitive screening tests/brief cognitive measures for dementia? A systematic review and meta-analysis

Fradera, A. , McLaren, J., Gadon, L., Cullen, B. and Evans, J. (2024) Does the presence of chronic pain affect scores on cognitive screening tests/brief cognitive measures for dementia? A systematic review and meta-analysis. Clinical Neuropsychologist, (doi: 10.1080/13854046.2024.2315739) (PMID:38369508) (Early Online Publication)

Abstract

Objective: Cognitive screening tests can identify potential dementia by indicating a concerning level of cognitive impairment. The older populations for whom this is most relevant are more likely to experience chronic pain, which also impairs cognitive function, but pain’s impact on cognitive screening tests specifically remains unknown. Method: We conducted a systematic review and meta-analysis (SR/MA) following PRISMA guidelines evaluating cognitive screening scores in studies involving participants with chronic pain compared with a pain-free control group. Our question was whether the presence of chronic pain (self-reported or based on diagnosis) was associated with poorer performance on these screens, and to identify the heterogeneity across groups and screens. Results: The 51 studies identified yielded 62 effect size estimates. The pooled g was 0.76 (95% confidence interval 0.57 to 0.95). Heterogeneity was high for the full model (= 93.16%) with some reductions in sub-analyses. Around half of the studies were identified as being at a low risk of bias. There was no evidence of publication bias. Conclusions: As a whole, this analysis suggests medium to large effect sizes on cognitive screen performance when people are living with chronic pain. We suggest that clinicians should consider the effect of chronic pain when cognitive screens are employed to investigate dementia. Further research could clarify the effect pain has on different screen sub-domains to aid their effective use with these populations.

• Item Type: Articles
• Keywords: Dementia, pain, cognition, cognitive screen, meta-analysis.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Evans, Professor Jonathan and Cullen, Dr Breda and Fradera, Dr Alexander

Creator Roles

Fradera, A.: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Visualization, Writing – original draft, Writing – review and editing
Cullen, B.: Conceptualization, Methodology, Writing – review and editing
Evans, J.: Conceptualization, Methodology, Writing – review and editing

• Authors: Fradera, A., McLaren, J., Gadon, L., Cullen, B., and Evans, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Clinical Neuropsychologist
• Publisher: Taylor and Francis
• ISSN: 1385-4046
• ISSN (Online): 1744-4144
• Published Online: 18 February 2024
• Copyright Holders: Copyright © 2024 The author(s)
• First Published: First published in Clinical Neuropsychologist 2024
• Publisher Policy: Reproduced under a Creative Commons licence