Association of osteoarthritis and pain with Alzheimer's Diseases and Related Dementias among older adults in the United States

Background: Emerging evidence suggests that Pain Interference (PI) and certain chronic pain conditions, including Osteoarthritis (OA) may be associated with risk for Alzheimer's disease and Related Dementias (ADRD). However, research exploring the relation of OA and PI to ADRD remains sparse. Objective: To assess the association of OA and PI to ADRD using cross-sectional data from a representative sample of USA adults aged ≥65 years. Design: Retrospective cross-sectional. Study sample: Older adults (age ≥ 65 years) drawn from the Medical Expenditure Panel Survey (MEPS, 2009–2015). Methods: OA was identified using both medical conditions files and participant responses to arthritis-specific queries. ADRD was ascertained using the medical conditions files. PI was defined as reported frequent PI with normal activities (PIA). OA and PIA were categorized as a composite variable: 1) OA with PIA; 2) OA without PIA; 3) No OA with PIA; and 4) No OA and no PIA (reference group). Adjusted associations of OA and PIA to ADRD were assessed using logistic regression and adjusted for biological, demographic, socio-economic, lifestyle, and health conditions. Results: Overall, 27.1% had OA, of whom 47.6 % reported PIA vs 31.1% of those without OA; 2.8% had diagnosed ADRD. Adults with PIA either with or without OA had significantly higher odds of ADRD relative to those without OA or PIA (Adjusted odd ratios (AOR's) = 1.37, 95%CI – 1.01, 1.86 (p = 0.04) and 1.44, 95%CI – 1.13, 1.82 (p = 0.003), respectively). Conclusion: PIA in both the presence and absence of OA remained significantly and positively associated with ADRD after adjustment for multiple confounders.