Background: About 50% of caregivers experience chronic pain. 25% experience pain that limits daily activities. Dementia caregivers are themselves at increased risk of cognitive decline and the development of dementia. Physical strain and chronic stress associated with caregiving may exacerbate pain and may adversely affect caregiver health. Few studies have directly compared pain and cognitive performance between dementia caregivers and non-caregivers over time

Methods: Twenty-one caregivers and seventy-four non-caregivers were enrolled in the study. Pain intensity and pain interference were collected on visual analog scales weekly and Montreal Cognitive Assessment (MoCA) scores were collected at baseline and at twelve months. 

Results: Caregivers and non-caregivers did not differ by sex or educational attainment. Caregivers were significantly younger than non-caregivers (mean age 71.3 vs 77.3 years) and demonstrated significantly lower MoCA scores (21.2 vs 25.2; p < 0.0001). After adjustment for age, caregivers reported significantly higher pain intensity compared with non-caregivers (odds ratio = 1.42, 95% CI = 1.00–2.01; p = 0.048).

Conclusions: Dementia caregivers exhibited significantly higher pain intensity and lower cognitive performance compared with non-caregivers over a 12-month period. These findings identify caregivers as a potentially vulnerable population for adverse cognitive outcomes and suggest that pain may represent an important, yet understudied, factor contributing to caregiver cognitive health. Further research is needed to clarify the mechanisms linking caregiving, pain, and cognition and to determine whether targeted pain intervention.