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Purpose <p>As the global population ages, chronic pain and cognitive decline are two of the most prevalent and debilitating conditions in older adults. Evidence shows a complex, bidirectional relationship between them, underpinned by shared neurobiological mechanisms like chronic neuroinflammation, neurotransmitter dysregulation, and network-level brain disruptions. Despite their interconnectedness, these conditions are often managed independently, limiting therapeutic effectiveness. This review highlights chronic pain as an overlooked modifiable risk factor in dementia prevention, integrating it into broader dementia risk reduction literature by emphasizing its role in exacerbating cognitive vulnerability and guiding targeted interventions.</p> Methods <p>This narrative review uses a systems neuroscience perspective to synthesize research on overlapping pathophysiology of chronic pain and cognitive impairment. It explores mechanisms such as emotional dysregulation, large-scale brain network dysfunction, and systemic frailty. It also evaluates artificial intelligence (AI)’s emerging role in enhancing diagnosis, treatment, and monitoring of this comorbid burden.</p> Results <p>Findings indicate persistent nociceptive input may exacerbate neurodegenerative processes, while cognitive deficits heighten pain sensitivity and impair coping, creating a self-perpetuating cycle. Traditional siloed care models fail to address this interplay. AI technologies, integrating multimodal data like neuroimaging, digital biomarkers, and behavioral metrics, enable early detection, individualized care, and dynamic monitoring.</p> Conclusion <p>A paradigm shift to unified, adaptive care models is essential for preserving autonomy and function in aging populations. Integrating AI into neurogeriatrics provides promising avenues for precision medicine but requires attention to ethical, technical, and implementation challenges. This review calls for interdisciplinary collaboration and translational research to operationalize equitable, mechanism-based interventions for older adults with pain–cognition comorbidity.</p>

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Aging-Associated Changes in Chronic Pain and Cognition: Mechanisms, Interrelations, and the Role of Artificial Intelligence in Optimized Management

  • 期刊论文

  • 发表日期：

    2026年2月20日

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  • Aidin Shahrezaei,
  • Jaleh Shoshtarian Malak,
  • Lili Dashti,
  • Sepideh Marjaei,
  • Farinaz Nasirinezhad

摘要

Purpose

As the global population ages, chronic pain and cognitive decline are two of the most prevalent and debilitating conditions in older adults. Evidence shows a complex, bidirectional relationship between them, underpinned by shared neurobiological mechanisms like chronic neuroinflammation, neurotransmitter dysregulation, and network-level brain disruptions. Despite their interconnectedness, these conditions are often managed independently, limiting therapeutic effectiveness. This review highlights chronic pain as an overlooked modifiable risk factor in dementia prevention, integrating it into broader dementia risk reduction literature by emphasizing its role in exacerbating cognitive vulnerability and guiding targeted interventions.

Methods

This narrative review uses a systems neuroscience perspective to synthesize research on overlapping pathophysiology of chronic pain and cognitive impairment. It explores mechanisms such as emotional dysregulation, large-scale brain network dysfunction, and systemic frailty. It also evaluates artificial intelligence (AI)’s emerging role in enhancing diagnosis, treatment, and monitoring of this comorbid burden.

Results

Findings indicate persistent nociceptive input may exacerbate neurodegenerative processes, while cognitive deficits heighten pain sensitivity and impair coping, creating a self-perpetuating cycle. Traditional siloed care models fail to address this interplay. AI technologies, integrating multimodal data like neuroimaging, digital biomarkers, and behavioral metrics, enable early detection, individualized care, and dynamic monitoring.

Conclusion

A paradigm shift to unified, adaptive care models is essential for preserving autonomy and function in aging populations. Integrating AI into neurogeriatrics provides promising avenues for precision medicine but requires attention to ethical, technical, and implementation challenges. This review calls for interdisciplinary collaboration and translational research to operationalize equitable, mechanism-based interventions for older adults with pain–cognition comorbidity.