Chronic Pain and the Risk of Dementia: A Systematic Review and Meta-Analysis.

Authors

Qingxiu Lin, Nianzhuang Qiu, Xingxing Wang, Ya Bin Wei, Jia Jia Liu

Published in

Current pain and headache reports. Volume 30. Issue 1. Jul 22, 2026. Epub Jul 22, 2026.

Abstract

The relationship between chronic pain and dementia risk has been extensively studied, but findings remain inconclusive. We conducted an updated meta-analysis to synthesize evidence from recent large-scale cohort studies.
Two authors independently and systematically searched PubMed, Web of Science, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure for cohort studies published through April 2025, with a minimum follow-up of one year. Hazard ratios (HRs) were considered equivalent to risk ratios (RRs) assuming low event rates. Random-effect models pooled risk ratios (RR) with 95% confidence intervals (CI). Subgroup analyses and meta-regression explored heterogeneity.
Of 3,823 publications, 30 studies met the inclusion criteria. After excluding five studies with overlapping populations, 25 studies involving 2,091,835 participants were pooled in the primary analysis. Individuals with chronic pain had a 28% higher dementia risk (RR = 1.28, 95% CI = 1.18-1.38). Heterogeneity was high (I²=91%). Subgroup analyses showed migraine, headaches, arthritis-related pain, and widespread pain were associated with increased risk. The association was significant in Asia but not in America or Europe, and when using ICD (but not DSM) criteria. Chronic pain increased the risk of Alzheimer's disease and non-vascular dementia, but not vascular dementia. Study quality, region, measurement methods, and pain types influenced the relationship. Pain type was a source of heterogeneity.
In this meta-analysis of cohort studies, chronic pain was associated with an increased risk of dementia. Due to the observational nature of the included studies and high heterogeneity, this association should not be interpreted as causal. Further research is needed to determine whether pain management can mitigate dementia risk.

PMID:
42484959
Bibliographic data and abstract were imported from PubMed on 22 Jul 2026.

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