Less efficient cognitive pain modulation in healthy older adults – the impact of executive functions, chronic stress, and physical activity

Demographic change and the associated increasing prevalence of chronic pain have contributed
to increased research interest in the field of aging. Aging has been associated with less efficient
pain inhibition through cognitive distraction. As pain modulation and executive functioning mainly
involve the prefrontal cortical network, which shows age-related atrophy, we hypothesized an
association between deteriorating cognitive modulation of pain in healthy older adults and reduced
executive functions. As chronic stress can decrease executive functioning through prefrontal
cortical impairment, we expected a negative impact on distraction from pain. In contrast, physical
activity can have a stress-buffering effect and positively influences executive functions in older age.
Therefore, increased physical activity should lead to better distraction from pain. Healthy young
(18 -30 years) and older adults (65+ years) took part in a pain distraction paradigm (N-back)
while receiving non-painful and moderately painful electric stimuli. Before, we examined executive
functions, including response inhibition (Go/No-Go-task), inhibitory control (Stroop task), and
working memory (Sternberg task). Additionally, chronic stress and physical activity were assessed
using self-report questionnaires, supported by physiological measurements (heart rate variability).
Preliminary results indicate a negative impact of chronic stress on distraction from pain particular
in young participants, while physical fitness was related to more successful pain modulation in older
adults. Our final results will contribute to a more differentiated view on executive functioning and
pain modulation in aging, thereby leading to a better understanding of the impact of aging on
non-pharmacological pain treatment and to better adapted pain therapies in this population.