Pain and … um … I Forgot …
Chronic pain and memory problems
Back to the point. It's important to keep in mind that the subjects of the study were 60 years old and older, generally the ages when people really start complaining about changes in their cognitive abilities and memory function, anyway. In addition, the study didn’t show a cause-and-effect relationship between persistent pain and memory issues, but instead showed an association between them. Not everyone who copes with frequent or daily pain will have or develop memory problems.
Faster decline on memory tests over time
“Those who had moderate or severe chronic pain in both 1998 and 2000 had more than a 9 percent faster decline on memory tests over the next 10 years than those who didn't have pain,” the researchers stated. “The decrease in memory would likely be enough to affect people's ability to do things such as manage their finances or keep track of their medications.”
I just turned the big 6-0 last fall, but I’ve had trouble with those tasks (chores—let’s be honest) for freaking years. I’ve always blamed it on being born that way—forgetful, a little absent-minded, being a head-in-the-clouds creative-type—but maybe having had to cope with frequent, sometimes daily, and often severe pain for decades might have something to do with it, too?
Increased risk of dementia
People with chronic pain also showed a small “but significantly increased risk” of dementia, according to the study, which was conducted by University of California, San Francisco, researchers and published on June 5 in the journal JAMA Internal Medicine.
So you think just because you’re still a spring chicken this isn’t going to be a problem for you (at least, not for a few more decades)? A 2012 article in the magazine Scientific American suggests that chronic pain can affect anyone’s memory, regardless of age.
Scientific evidence regarding chronic pain and concentration
Researchers at the University of Alberta showed that chronic pain can impair both concentration and memory—again, something that most of us already know, but it’s nice to see the science back us up.
How does chronic pain affect concentration?
“After studying 24 patients, Drs. Bruce D. Dick and Saifudin Rashiq seem to have zeroed in on one of the cognitive mechanisms affected by chronic pain,” states an article about the study in Science Daily. “Their findings, published in the latest issue of Anesthesia and Analgesia, suggest that pain may disrupt the maintenance of the memory trace that is required to hold information for processing and retain it for storage in longer-term memory stores. In other words, chronic pain can, quite literally, drive people to distraction.”
I don’t know about you, but it’s really hard for me to concentrate when my pain passes a certain level. There’s a point when it seems like the pain is the only thing in my life. Likewise, the more I hurt, the more distracted and forgetful I tend to be. To me, this is a simple cause-and-effect issue: the more I hurt, the duller-minded I get. And that was as true when I was 31 as it is now.
The impact of chronic pain on brain anatomy
Another study from Northwestern University showed that people with chronic pain have an impaired hippocampus—the part of the brain that’s “critical for learning, memory, and emotional processing.” People with Chronic Regional Pain Syndrome (CRPS) and lower back pain, they found, had a smaller hippocampus than healthy subjects. Might chronic pain affect cognition?
Studying brain anatomy in mice with chronic pain
In an attempt to learn more, they studied mice with chronic pain and found that the animals “had trouble with a test of emotional learning, and they displayed greater anxiety-like behaviors than normal mice. In the hippocampus, electrical and biochemical signaling was disrupted. Perhaps most striking was the mice's failure to produce new neurons in the hippocampus—one of the few brain areas where adult mice and humans can grow new neurons,” states the article.
There is good news, though. According to research cited on the Memory Foundation’s website regarding the correlation between chronic pain and a smaller hippocampus, “the reduction in size can be reversed when the pain itself is treated.”
Chronic pains affects daily activities
It's hard to argue that coping with frequent, persistent pain doesn’t have an effect on a person’s ability to think clearly, remember everything they need to, or do tasks or chores as efficiently as they might without the pain. Pain also affects sleep patterns, which can make us more fuzzy-minded, particularly if we’ve lost sleep over a series of nights. Pain has a huge emotional effect, as well. Anger, sadness, depression—all of these can affect our memory and/or cognitive abilities.
Various ways to manage forgetfulness
And that’s why, for more years than I like to admit, I’ve lived with a pad of notepaper and a pen close at hand. I make myself lists so I don’t forget the important stuff. (Most of the time, anyway!) I add to grocery lists as I think of items or notice we're running low on them instead of trying to remember them later, when I'm pushing a basket down the aisles. I keep a calendar with big boxes on the kitchen counter—and I write appointments, etc. on it each month. I love my smart phone: the alarm function lets me schedule alarms for things like taking my meds at certain times, even on certain days. And I'm slowly learning to use it, too, for lists.
Trying not to stress about the little things
But most of all, I’ve learned not to stress over the small things that slip down the memory hole. So I forgot to water the tomatoes today! Oh well, tomorrow will do—and I’ll remember to do it, too. I safety-pinned a note to my bra so when I get up and get dressed in the morning, I can’t miss it!
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?