OBJECTIVES : Emerging evidence suggest that pain and osteoarthritis (OA) may be associated with Alzheimer’s disease and Related Dementia (ADRD). Our objective was to assess the association of osteoarthritis and pain with ADRD in older adults (age ≥ 65 years) in the USA.

METHODS :

A retrospective cross-sectional design was adopted by using Medical expenditure panel survey (MEPS). Pain was measured with reported pain interference with normal activities (PIA). The key independent variable was categorized as: 1) OA with PIA; 2) OA without PIA; 3) PIA in the absence of OA and 4) absence of both OA and PIA. The presence or absence of ADRD was identified from the medical conditions files. Unadjusted and adjusted associations of osteoarthritis and PIA categories with ADRD were tested with logistic regressions.

RESULTS :

Overall, 27.2% had osteoarthritis; nearly 1 in 2 older adults with osteoarthritis and 1 in 3 older adults without OA reported PIA; Less than 5% (3.8%) reported ADRD. In fully-adjusted models, elderly with PIA with OA (AOR = 1.55, 95% CI= 1.19, 2.03; p=0.0.015) or without OA (AOR = 1.63, 95% CI= 1.35, 1.96; p<0.0001) had higher odds of ADRD as compared to those without OA and without PIA. Elderly with OA and without PIA had lower odds of ADRD (AOR = 0.68, 95% CI= 0.47, 0.98; p =0.369), in the adjusted logistic regression.

CONCLUSIONS :

Moderate to severe PIA in both the presence and the absence of OA remained strongly and positively associated with ADRD after adjustment for multiple potential confounders. In contrast, OA in the absence of PIA was unrelated or inversely associated with ADRD relative to absence of both conditions. Future prospective studies need to confirm these findings.