Subjective memory concerns and cognitive aging in Puerto Rican older adults: The moderating role of chronic pain

Background and Objectives Older Puerto Rican adults face disproportionately high dementia rates, and subjective memory concerns (SMCs) are often the earliest sign of cognitive risk. The role of chronic pain in shaping SMC-cognition associations is poorly understood. We evaluated two SMC items as predictors of cognition and tested whether chronic pain moderated these associations. Methods Participants without cognitive impairment (n = 575; mean age = 83.90) came from the Puerto Rican Elderly: Health Conditions (PREHCO) study and were reassessed approximately 2 years later (n = 433). Chronic pain was defined as pain reported at baseline and in prior waves. SMC items and cognition were modeled in adjusted regression models. Results Perceived memory difficulty, but not perceived memory decline, was associated with worse baseline cognitive status (β=-.14, p=.003) and episodic memory (β=-.12, p=.008), and with greater episodic memory decline (β=-.13, p=.013). Chronic pain moderated the associations of perceived memory difficulty with baseline (β=-.21, p=.037) and change in episodic memory (β=.39, p=.006). Among participants with chronic pain, greater perceived memory difficulty corresponded to poorer concurrent episodic memory (β=-.28, p=.003) but was not associated with change in episodic memory (p=.393). Among those without chronic pain, perceived memory difficulty was not associated with concurrent episodic memory (p=.170) but showed a positive association with subsequent decline (β=-.15, p=.005). Discussion and Implications Associations of perceived memory difficulty with episodic memory differed by chronic pain status: in the chronic pain group, SMCs tracked concurrent memory performance; in those without pain, they were associated with future episodic memory decline.