Cognitive and functional impairment in an older community population from Brazil: The intriguing association with frequent pain

• A community-based survey to investigate cognitive impairment is proposed.
• A large sample of elderly people and a wide set of clinical conditions are examined.
• The results show the contribution of diverse known factors.
• Surprisingly, frequent pain is independently associated with cognitive impairment.
• The role of frequent pain in the course of cognitive impairment should be examined.

ObjectiveThis cross-sectional community-based epidemiologic survey aimed to investigate the prevalence of cognitive and functional impairment (CFI) and its distribution in relation to socio-demographic and clinical factors in an older community sample in Florianópolis, Brazil.Materials and methodsThe population was a representative sample aged 60 and older; the cluster sample strategy was performed. CFI, a syndromic category that does not exclude dementia, was defined according to the combination of low MMSE (Mini-Mental State Examination) score and moderate/severe dependence in a scale that measured activities of daily living. The data were submitted to multiple regression analysis using the Poisson regression method.ResultsA sample of 1705 subjects was interviewed; the mean age was 70.6 years (60–104 years; SD: 8.0); 63.9% were female and 43.7% had up to 4 years of schooling. CFI was detected in 325 subjects, resulting in a raw prevalence of 19.2% (95% CI: 17.3–21.0). Older age, presence of diabetes, heart disease, stroke, urinary incontinence, arthritis, frequent pain and depression were significantly associated with CFI (p < 0.05).ConclusionIn addition to the diversity of factors associated with CFI, the present study indicated the need to investigate the role of frequent pain in the development and progression of cognitive impairment and dementia.