Assessing the Between- and Within-Person Relationships between Pain and Cognitive Performance in Older Adults

Abstract

The current study was part of a larger study where overarching purpose was to design a daily measure of everyday cognitive performance. The current investigation examined the extent to which self-report pain was related to cognitive performance in a sample of 148 community dwelling older adults (M = 73 years old, SD = 6.84). A multidimensional battery was used to assess socio-demographics, physical health (e.g. self-report pain, self-report physical health), mental health (e.g. negative affect, life-event stress, and daily stress), and cognitive functioning (e.g. short-term memory, processing speed, inductive reasoning, and working memory) at pretest and over 8 occasions. The direct relationship between self-report pain and cognition was examined as well as potential moderators and mediators of the pain-cognition relationship both at the between- and within-person levels. At the between-person level, self-reported pain was found to be significantly related to processing speed, where high pain was associated with slower reaction time. At the within-person level self-reported pain was found to be significantly related to working memory, where on days when self-reported pain was higher than an individual’s average, their working memory performance suffered. Within-person self-reported pain X age interactions were found for short-term memory, processing speed, and working memory. Additionally, negative affect and stress were found to moderate the pain-cognition relationship. The strength of the pain-cognition relationship is best understood by examining moderating factors such as age, stress, and negative affect. Furthermore, the handful of significant interactions at the within-person level suggest that the pain-cognition relationship is dynamic and should not be assessed at only one time point.