J Aging Health. 2021 Aug 05;8982643211036219. doi: 10.1177/08982643211036219. Epub 2021 Aug 05.
Increased Odds of Incident Alzheimer's Disease and Related Dementias in Presence of Common Non-Cancer Chronic Pain Conditions in Appalachian Older Adults.
Journal of aging and health
Sumaira Khalid, Usha Sambamoorthi, Amna Umer, Christa L Lilly, Diane K Gross, Kim E Innes
Affiliations
Affiliations
- Department of Epidemiology, 5631West Virginia University, School of Public Health, Morgantown, WV, USA.
- Department of Pharmaceutical Systems and Policy, 5631West Virginia University, School of Pharmacy, Morgantown, WV, USA.
- Department of Pediatrics, 5631West Virginia University, School of Medicine, Morgantown, WV, USA.
- Department of Biostatistics, 5631West Virginia University, School of Public Health, Morgantown, WV, USA.
PMID: 34351824
DOI: 10.1177/08982643211036219
Abstract
BACKGROUND: There is a growing concern regarding the increasing prevalence of common non-cancer chronic pain conditions (NCPCs) and their possible association with Alzheimer's disease and related dementias (ADRD). However, large population-based studies are limited, especially in Appalachian and other predominantly rural, underserved populations who suffer elevated prevalence of both NCPCs and known ADRD risk factors.
OBJECTIVES: We investigated the relation of NCPC to risk of incident ADRD in older Appalachian Medicare beneficiaries and explored the potential mediating effects of mood and sleep disorders.
METHODS: Using a retrospective cohort design, we assessed the overall and cumulative association of common diagnosed NCPCs at baseline to incident ADRD in 161,573 elders ≥65 years, Medicare fee-for-service enrollees, 2013-2015. NCPCs and ADRD were ascertained using claims data. Additional competing risk for death analyses accounted for potential survival bias.
MAIN FINDINGS: Presence of any NCPC at baseline was associated with significantly increased odds for incident ADRD after adjustment for covariates [adjusted odds ratio (AOR) = 1.26 (1.20, 1.32),
CONCLUSION: In this large cohort of older Appalachian Medicare beneficiaries, baseline NCPCs showed a strong, positive, dose-response relationship to odds for incident ADRD; this association appeared partially mediated by depression and anxiety. Further longitudinal research in this and other high-risk, rural populations are needed to evaluate the causal relation between NCPC and ADRD.
Keywords: Alzheimer’s disease and related dementias; Appalachia; West Virginia Medicare; chronic pain; older adults; retrospective cohort study; rural population
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