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 2 SMC items as predictors of cognition and tested whether chronic pain moderated these associations. RESEARCH DESIGN AND 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 significant 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.