PDF(Pubmed)
Abstract：
The goal of this study is to investigate the association between chronic non-cancer pain (CNCP) and mild cognitive impairment (MCI)/Alzheimer\'s disease and related dementias (ADRDs) development among adults aged ≥50 using administrative claims data from a national commercial health insurance company during 2007-2017. To reduce selection bias, propensity-score matching was applied to select comparable CNCP and non-CNCP patients. Time-dependent Cox proportional-hazards regressions were conducted to estimate the hazard ratios (HRs) of incident MCI/ADRDs. Of 170,900 patients with/without CNCP, 0.61% developed MCI and 2.33% had been diagnosed with ADRDs during the follow-up period. Controlling for potential confounders, CNCP patients had a 123% increase in MCI risk (HR = 2.23; 95% CI = 1.92-2.58) and a 44% increase in ADRDs risk (HR = 1.44; 95% CI = 1.34-1.54) relative to non-CNCP patients. CNCP is a risk factor for MCI/ADRDs. Promoting awareness and improving early CNCP diagnosis in middle-aged and older adults should be incorporated into cognitive impairment and dementia prevention.
摘要：
这项研究的目的是调查慢性非癌性疼痛（CNCP）与轻度认知障碍（MCI）/阿尔茨海默病和相关痴呆（ADRD）发展的年龄≥50岁的成年人使用行政索赔数据在2007年至2017年期间的国家商业健康保险公司。为了减少选择偏差，倾向评分匹配用于选择具有可比性的CNCP和非CNCP患者.进行时间依赖性Cox比例风险回归以估计事件MCI/ADRD的风险比（HR）。在有/没有CNCP的170,900名患者中，在随访期间，0.61％发展为MCI，2.33％被诊断为ADRD。控制潜在的混杂因素，与非CNCP患者相比，CNCP患者的MCI风险增加123%（HR=2.23；95%CI=1.92-2.58），ADRD风险增加44%（HR=1.44；95%CI=1.34-1.54）。CNCP是MCI/ADRD的风险因素。提高中老年人对CNCP的认识和早期诊断应纳入认知障碍和痴呆的预防。
