Does the presence of chronic pain affect scores on cognitive screening tests/brief cognitive measures for dementia? A systematic review and meta-analysis.

IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Clinical Neuropsychologist Pub Date : 2024-10-01 Epub Date: 2024-02-18 DOI:10.1080/13854046.2024.2315739
Alex Fradera, Jessica McLaren, Lisa Gadon, Breda Cullen, Jonathan Evans
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Abstract

Objective: Cognitive screening tests can identify potential dementia by indicating a concerning level of cognitive impairment. The older populations for whom this is most relevant are more likely to experience chronic pain, which also impairs cognitive function, but pain's impact on cognitive screening tests specifically remains unknown.

Method: We conducted a systematic review and meta-analysis (SR/MA) following PRISMA guidelines evaluating cognitive screening scores in studies involving participants with chronic pain compared with a pain-free control group. Our question was whether the presence of chronic pain (self-reported or based on diagnosis) was associated with poorer performance on these screens, and to identify the heterogeneity across groups and screens.

Results: The 51 studies identified yielded 62 effect size estimates. The pooled g was 0.76 (95% confidence interval 0.57 to 0.95). Heterogeneity was high for the full model (= 93.16%) with some reductions in sub-analyses. Around half of the studies were identified as being at a low risk of bias. There was no evidence of publication bias.

Conclusions: As a whole, this analysis suggests medium to large effect sizes on cognitive screen performance when people are living with chronic pain. We suggest that clinicians should consider the effect of chronic pain when cognitive screens are employed to investigate dementia. Further research could clarify the effect pain has on different screen sub-domains to aid their effective use with these populations.

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慢性疼痛是否会影响痴呆认知筛查测试/简易认知测量的得分?系统回顾与荟萃分析。
目的:认知筛查测试可以通过显示认知障碍的相关程度来识别潜在的痴呆症。与此最相关的老年人群更有可能经历慢性疼痛,而慢性疼痛也会损害认知功能,但疼痛对认知筛查测试的具体影响仍不得而知:我们按照 PRISMA 指南进行了一项系统回顾和荟萃分析(SR/MA),评估了与无痛对照组相比,有慢性疼痛参与者参与的研究中的认知筛查得分。我们的问题是,慢性疼痛的存在(自我报告或基于诊断)是否与这些筛查的较差表现有关,并确定不同组别和筛查之间的异质性:51 项研究得出了 62 个效应大小估计值。汇总的 g 为 0.76(95% 置信区间为 0.57 至 0.95)。完整模型的异质性很高(=93.16%),但在子分析中异质性有所降低。约有一半的研究被认定为存在低偏倚风险。没有证据表明存在发表偏倚:总体而言,这项分析表明,当人们患有慢性疼痛时,认知屏幕表现会产生中等到较大的影响。我们建议临床医生在使用认知筛查来调查痴呆症时应考虑慢性疼痛的影响。进一步的研究可以明确疼痛对不同筛查子域的影响,从而帮助这些人群有效使用筛查。
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来源期刊
Clinical Neuropsychologist
Clinical Neuropsychologist 医学-临床神经学
CiteScore
8.40
自引率
12.80%
发文量
61
审稿时长
6-12 weeks
期刊介绍: The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
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