Chronic musculoskeletal pain and its relationship with cognitive function in older adults: A systematic review and meta-analysis.

Background: The relationship between chronic musculoskeletal pain and cognitive function in older adults remains unclear. This study aimed to investigate whether the cognitive function of older adults with chronic musculoskeletal pain differs from asymptomatic older adults.

Methods: Four databases (PubMed, Science Direct, Web of Science, and Scopus) were searched. Two researchers independently reviewed the references against the eligibility criteria and performed the quality assessment of included studies using The National Institutes of Health (NIH) - Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results: A total of 8484 references were found and ten articles, published between 2006 and 2021, were included. Only one study was classified as being of good quality, the remaining were of fair quality. Independent meta-analysis were performed for global cognition and specific cognitive domains (language, attention/orientation, executive function, memory, processing speed, and visuospatial skills). Differences between older adults with and without chronic musculoskeletal pain were found for the domains of general cognition (k = 10; d = -0.20; 95% CI = -0.38, -0.03; z = -2.25, p = 0.03) and language (k = 8; d =  -0.16; 95% CI = -0.28, -0.05; z = -2.72, p = 0.006), with very low certainty of evidence.

Conclusion: Overall, and considering the very low certainty of evidence for both global cognition and specific cognitive domains, we are uncertain about whether cognitive function differs between older adults with and without chronic musculoskeletal pain. Further research is needed comparing cognitive performance between older adults with and without chronic musculoskeletal pain, on the long-term impact of pain on cognitive functioning, and on the mechanisms underlying this potential relationship.