Chronic pain is increasingly linked with memory and thinking problems, but the relationship is complex. Research suggests that long lasting, moderate to severe pain is associated with faster cognitive decline and may affect some types of thinking more than others.
Many people living with chronic pain say they feel forgetful, “foggy,” or unable to concentrate. Scientists have started to study this more closely. A recent large study presented at the Alzheimer’s Imaging Consortium reported that moderate to severe chronic pain was associated with faster overall cognitive decline and signs of general brain degeneration, likely involving changes in amyloid beta, a protein tied to Alzheimer’s disease.https://pubmed.ncbi.nlm.nih.gov/41433533/ This suggests that ongoing pain is not only uncomfortable, but may also influence long term brain health.
Other work has looked at specific pain conditions. In people with chronic low back pain, researchers have found a higher rate of mild cognitive impairment compared with the general population, reinforcing a link between this type of long term pain and problems with thinking abilities.https://www.neurology-asia.org/articles/neuroasia-2025-30(4)-1143.pdf Mild cognitive impairment can involve issues with memory, attention, and planning that are noticeable but not yet severe enough to be called dementia.
At the same time, not all studies find a simple, direct hit to memory itself. A large experimental study in people with chronic migraine and chronic low back pain tested how pain during a task affected recognition memory.https://academic.oup.com/braincomms/article/8/1/fcaf486/8376909 The researchers found that painful stimulation made it harder for everyone to remember pictures later, but this effect was similar in people with chronic pain and in healthy volunteers. However, when they gave a broader set of thinking tests, they discovered something important. People with chronic migraine showed reduced verbal flexibility, and people with chronic low back pain had more trouble with divided attention. This points to a pattern where chronic pain may particularly affect attention and executive functions, which then indirectly hurt memory performance in daily life.
In older adults, chronic pain may combine with other risk factors and create a bigger impact. A 2025 study of older U.S. military veterans found that chronic pain, poor sleep, and lower resilience were all linked with a higher risk of subjective cognitive decline, meaning people felt their memory and thinking were getting worse over time.https://journals.sagepub.com/doi/10.1177/25424823251407258 When someone is dealing with constant pain, especially in later life, it can therefore add to other pressures on brain function.
Sleep is one pathway that helps explain the connection between pain and memory. Chronic pain often disrupts sleep, and poor sleep is known to harm memory and concentration. For example, a study of men over 65 with back pain found that back pain predicted worse sleep quality years later, including irregular sleep times and greater dissatisfaction with sleep.https://www.psu.edu/news/health-and-human-development/story/back-pain-linked-worse-sleep-years-later-men-over-65-according The researchers pointed out that poor sleep itself is linked with memory problems and mood issues. In this way, chronic pain may indirectly damage memory by making it much harder to get restorative sleep.
There are also biological reasons why chronic pain might be tied to memory decline. Long term pain is associated with ongoing stress responses and inflammation in the body and brain. Over time, this can affect regions involved in memory and attention, such as the hippocampus and prefrontal cortex. The Alzheimer’s Imaging Consortium report suggests that chronic pain may accelerate neurodegeneration through pathways that involve amyloid beta build up and possibly other brain changes.https://pubmed.ncbi.nlm.nih.gov/41433533/ While the exact chain of events is still being mapped, this lines up with brain imaging findings in other chronic pain conditions that show structural and functional changes in key cognitive areas.
Attention is another key piece. Pain is a powerful signal that naturally grabs mental focus. If someone is in pain every day, a large part of their attention is constantly pulled toward the discomfort, worries about it, or efforts to avoid worsening it. The Brain Communications study in migraine and back pain showed that pain affected attention similarly in those with and without chronic pain, but people with chronic pain had additional weaknesses in executive control systems.https://academic.oup.com/braincomms/article/8/1/fcaf486/8376909 Since forming new memories depends heavily on focused attention, ongoing distraction from pain can make it harder to remember conversations, appointments, or details from reading, even if the brain’s basic memory machinery is still intact.
Mental health adds another layer. Chronic pain is strongly associated with anxiety and depression, both of which are independently linked with memory and concentration problems. Someone might notice forgetfulness and slow thinking and attribute it purely to aging, when it is actually a combined effect of pain, poor sleep, low mood, and stress. Subjective cognitive decline, as studied in the older veteran population, captures this lived experience of “my mind is not working like it used to,” which often shows up before clear changes appear on detailed tests.https://journals.sagepub.com/doi/10.1177/25424823251407258
It is also important to note that not everyone with chronic pain will go on to develop dementia or major memory loss. The risk appears to rise with pain that is more intense, more widespread, and more persistent, especially when combined with other factors like poor sleep, cardiovascular disease, low physical activity, and social isolation. The chronic low back pain study that found 16 percent of patients had mild cognitive impairment highlights that a notable minority are affected, which is enough
