Pain duration as a staging variable: A conceptual framework for testing depression-pathway interventions in dementia risk

Abstract

This study proposes a conceptual framework for testing the role of pain duration as a staging variable in the relationship between chronic pain and dementia risk. Chronic pain duration, often associated with an increased risk of dementia, may influence how depression interacts with cognitive decline. In this article, we propose two hypotheses for future research: (H1) In the 3–24 months period, depression-targeted care through interventions such as cognitive behavioral therapy and antidepressant medication is expected to provide the most significant cognitive benefits. (H2) After 24 months, depression care remains important, but its effectiveness may be limited without multimodal pain management, which includes physical therapy and pharmacological interventions. We also consider confounding variables such as comorbidities and sociodemographic factors that may influence study outcomes, which need to be accounted for in future research. This framework aims to provide a foundation for longitudinal research and intervention trials that test the proposed hypotheses, contributing to the development of more effective dementia prevention strategies for individuals with chronic pain.