Effect of pain relief intervention on cognition and quality of life in older adults with chronic post-stroke neuropathic pain

Pain and cognition share overlapping neural networks, and their interaction may impair daily functioning and quality of life (QoL). Clarifying whether alleviating pain contributes to cognitive improvement is critical for developing effective interventions for older adults. To examine the effects of a 12-week pain-targeted intervention on pain, cognitive function, and QoL in older adults with chronic post-stroke neuropathic pain. Forty-six older adults with post-stroke neuropathic pain were randomly assigned to either a pain treatment group (PTG, n = 23) or a control group (CON, n = 23). The PTG received a combined intervention of acupuncture and neurodevelopmental therapy twice weekly for 12 weeks. Pain (Visual Analog Scale [VAS], Shoulder Pain and Disability Index [SPADI], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), cognition (Motor-Free Visual Perception Test [MVPT-3], Grooved Pegboard Test [GPT]), and stroke-specific QoL (SS-QOL) were assessed at baseline and after 12 weeks. Significant group × time interaction effects were determined for VAS, SPADI, WOMAC, MVPT-3, GPT, and SS-QOL ( p < 0.01). Pain and cognition were inversely correlated: VAS with MVPT-3 ( p < 0.05) and SPADI with MVPT-3 ( p < 0.05). In regression analyses, changes in VAS significantly predicted improvements in GPT performance ( p = 0.001). Non-pharmacological pain interventions may provide significant benefits for pain, cognition, and QoL in older adults with post-stroke neuropathic pain. The findings underscore that reduced pain is closely linked to cognitive improvement, with pain relief emerging as a key determinant of cognitive-motor recovery. • Non-pharmacological pain relief combining acupuncture and neurodevelopmental therapy significantly improved pain, cognition, and quality of life in older adults with chronic post-stroke neuropathic pain. • Reductions in pain were strongly associated with cognitive improvements, extending previous research on pain–cognition relationships. • The predictive relationship between pain relief and cognitive improvement supports the potential of non-drug interventions to enhance brain function in older adults.