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We assessed the relationship of activity\u2010limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged \u226580.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010\u20132016). Pain interference, or pain that limited daily activities in the last 12\u2009months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring &lt;21 on the Mini\u2010Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6\u2010year period (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009313).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09\u20134.36; treated aOR: 1.99; 95% CI: 1.15\u20133.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic\/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non\u2010pharmacological treatments in these pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18618","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T15:33:29Z","timestamp":1696520009000},"page":"226-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pain and incident cognitive impairment in very old Mexican American adults"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6631-6532","authenticated-orcid":false,"given":"Sadaf Arefi","family":"Milani","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Sanchez","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-0927","authenticated-orcid":false,"given":"Yong\u2010Fang","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Data Science University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5792-0527","authenticated-orcid":false,"given":"Brian","family":"Downer","sequence":"additional","affiliation":[{"name":"Department of Population Health &amp; Health Disparities University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-4641","authenticated-orcid":false,"given":"Soham","family":"Al Snih","sequence":"additional","affiliation":[{"name":"Department of Population Health &amp; Health Disparities University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriakos S.","family":"Markides","sequence":"additional","affiliation":[{"name":"Department of Population Health &amp; Health Disparities University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7460-7281","authenticated-orcid":false,"given":"Mukaila","family":"Raji","sequence":"additional","affiliation":[{"name":"Division of Geriatric and Palliative Medicine, Department of Internal Medicine University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.06.3063"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2174\/1567205016666181212162424"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2011.01.002"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv166"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.1622"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glac141"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17542"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.06.009"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17155454"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001932"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5713"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2021.01.086"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13562"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnx210"},{"key":"e_1_2_10_16_1","unstructured":"FreyWH.The US will become \u2018minority white\u2019 in 2045 Census projects: youthful minorities are the engine of future growth; 2018."},{"key":"e_1_2_10_17_1","unstructured":"Noe\u2010BustamanteL.Key facts about U.S. Hispanics and their diverse heritage. 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