Chronic Pain in the Chilean population: Risk factors prevalence and cognitive associations

Hernán Hernández¹Carolina Ochoa-Rosales¹Agustin Ibanez^1,2,3,4Lorena Oyanedel^5,6Loreto Olavarría^7,8Nickole Marín-Díaz¹Ariel Andrés Caviedes¹Jessica Hazelton^1,9Teresita Ramos Franco^10,11Hernando Santamaria-García^12,13,3Nilton Custodio¹⁴Rosa Montecinos¹⁴Martín Bruno^15,16José Alberto AVILA-FUNES^17,18Diana L Matallana^19,20,21,22Rolando de la Cruz^1,23,24Fanny Petermann-Rocha²⁵Andrea Slachevsky¹¹Claudia Duran-Aniotz^1*Carolina Gonzalez^1*

• ¹Latin American Institute for Brain Health (BrainLat), Adolfo Ibáñez University, Santiago, Santiago Metropolitan Region (RM), Chile
• ²Global Brain Health Institute, School of Psychology, Faculty of Arts, Humanities and Social Sciences, Trinity College Dublin, Dublin, Leinster, Ireland
• ³University of California, San Francisco, San Francisco, California, United States
• ⁴Centro de Neurociencias Cognitivas, Universidad de San Andrés, Buenos Aires, Buenos Aires, Argentina
• ⁵Hospital Clinico San Borja Arriaran, Santiago, Santiago Metropolitan Region (RM), Chile
• ⁶Pontificia Universidad Católica de Chile, Santiago, Santiago Metropolitan Region (RM), Chile
• ⁷Laboratory of Neuropsychology and Clinical Neurosciences, Faculty of Medicine, University of Chile, Santiago, Santiago Metropolitan Region (RM), Chile
• ⁸Facultad de Ciencias, Universidad Mayor, Santiago, Santiago Metropolitan Region (RM), Chile
• ⁹Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
• ¹⁰Finis Terrae University, Santiago, Santiago Metropolitan Region (RM), Chile
• ¹¹Memory Unit Neurology Service, Hospital del Salvador, Santiago, Chile., Santiago, Santiago Metropolitan Region (RM), Chile
• ¹²Pontifical Javeriana University, Bogotá, Cundinamarca, Colombia
• ¹³San Ignacio University Hospital, Bogotá, Cundinamarca, Colombia
• ¹⁴Instituto Peruano de Neurociencias, Lima, Perú., Lima, Peru
• ¹⁵Biomedical Science Institute, Faculty of Medicine, Universidad Católica de Cuyo, San Juan, Argentina., San Juan, Argentina
• ¹⁶Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina., Buenos Aires, Argentina
• ¹⁷INSERM U1219 Bordeaux Population Health Centre Recherche (BPH), Bordeaux, Aquitaine, France
• ¹⁸Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico., Mexico city, Mexico
• ¹⁹Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia., Bogotá, Colombia
• ²⁰Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia., Bogotá, Colombia
• ²¹Mental Health Department, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia., Bogotá, Colombia
• ²²Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia, Bogotá, Colombia
• ²³Faculty of Engineering and Sciences, Universidad Adolfo Ibáñez, Santiago, Chile., Santiago, Chile
• ²⁴Data Observatory Foundation, Santiago, Chile., Santiago, Chile
• ²⁵Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile., Santiago, Chile

Chronic pain (CP) is a global public health concern and a key factor in the aging process. Chile, one of the most aged countries in Latin America, offers a unique context to explore CP and its associated factors. Despite CP’s relevance in aging, regional studies often overlook critical variables such as age, income, mood, mobility, diet, and cognitive function. Moreover, few investigate the link between CP and cognitive impairment.This study analyzes CP prevalence and its associations using data from the 2009–2010 and 2016–2017 Chilean National Health Surveys (CNHS), representing individuals aged 15 years and older. In the expanded samples of 12.8 million and 13.4 million people, CP prevalence was 46.0% in 2009–2010 and 28.9% in 2016–2017, with prevalence increasing with age. In the 2009–2010 survey, CP ranged from 26.6% in ages 15–24 to 59.9% in ages 65–80, and from 16.6% to 40.2% in the same age groups in 2016–2017. Women consistently reported higher CP rates than men across all age groups from 15 to 64 years.Complex survey logistic regression analyses identified key factors significantly associated with CP: reduced mobility, symptoms of depression and anxiety, lower educational attainment, and socioeconomic disadvantage. Additionally, machine learning techniques were used to classify CP and non-CP cases, revealing complex interactions among predictive variables.A secondary analysis among adults aged 60 and older assessed CP in relation to cognitive impairment using an abbreviated Mini-Mental State Examination. While CP prevalence did not significantly differ between cognitively impaired and unimpaired individuals, those with cognitive impairment reported pain in more anatomical sites.This study offers the first nationally representative evidence in Chile linking CP to aging, mental health, functional status, and social determinants. The findings highlight the urgent need for targeted policies to address CP as a multidimensional issue and to promote healthy aging. Addressing CP in Latin America is essential to reduce its burden and improve quality of life in older populations.