In terms of pain

This is what performance on these tests look like. Across, a sample of older, of adults age 20-90. And you can see that performance, regrettably for all of us in this room, begins declining in your 20’s and all the tasks – speed of processing, working memory, long-term memory – it doesn’t seem to matter whether the tasks are visual, spatial or verbal, they only task that seems to be protected from age is, as I mentioned, is world knowledge. Those are three measures of vocabulary. This data represents 350 subjects, 50 at each decade. These are all healthy, normal adults drawn from the community. So basically we are looking at two decade age differences. In other words, does fibromyalgia move patients two decades further along on this graph from their actual chronological age? So that’s sort of a little bit about the logic of the study.

As I mentioned, we have measures of sleep disturbance, depression, pain, fatigue anxiety. Beliefs about memory and there is some evidence that people’s memory functions differently when they are tested at their preferred time of day. Like if you are a morning person and you are tested in the evening, your memory will be worse. So we also looked at preferred time of day. But all of these patients were tested in the afternoon because of the salivary cortisol samples and the plasma cortisol.

Okay, what do our participants look like? The median age of the fibromyalgia patients was 47. You can see the older controls are exactly 20 years older and the age-matched controls are within a year of the age of the fibromyalgia patients. These are well-educated participants. The fibromyalgia patients score higher on the geriatric depression scale as well as the Beck Depression Inventory. I’ll make a comment about that in a moment. And they also report having more pain than the older adults and the age-matched controls. Graphically here’s the depression. We have two measures of depression. The point I want to make is that on the Beck Depression Inventory, mild depression is 19 and our patient’s score mean is 16 and on the GDS mild depression is 15 and our patients are at about a 12. So that even though they are significantly more depressed in a sense than the older controls and the age-matched controls, none of our subjects even meet the criteria for mild depression according to these well-known instruments.

In terms of pain, you can see that our patients, the FM patients, report more pain on two different measures: the Ames II and the McGill Pain Inventory compared to older controls and age-matched controls. We also have some chronic fatigue subjects that I didn’t include here because we only had 10 and it seemed an inadequate number. But the FM’s reliably report more pain and the chronic fatigues as well. Sleep quality: the FM patients and the older adults sleep somewhat more poorly than age-matched controls. So that’s sort of the background variables that you should keep in mind as we look at the cognitive function of these patients.

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