Pain and Cognitive Functioning in Adults with Down Syndrome

Nanda C. de Knegt, Frank Lobbezoo, Carlo Schuengel, Heleen M. Evenhuis, Erik J. A. Scherder

Research output: Contribution to JournalArticleAcademicpeer-review


Objective: The aim of the present study was to examine whether cognitive functioning (i.e., memory and executive functioning) is related to self-reported presence of pain (i.e., affirmative answer to the question whether the individual feels pain) and experience of pain (i.e., intensity and affect) in adults with Down syndrome (DS).

Design, Setting, and Subjects: Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) in the Netherlands.

Methods: File-based medical information was evaluated. Self-reported presence and experience of pain were assessed during a test session, both in rest and after movement (affect with the facial affective scale [FAS], intensity with the numeric rating scale [NRS]). Neuropsychological tests for memory and executive functioning were used.

Results: Participants with lower memory scores were more likely to report the presence of pain, while controlling for age, gender, physical conditions that may cause pain, language comprehension, and vocabulary ( p  = .030, 58.4% classification rate, N  = 154). No statistically significant associations were found between executive functioning and self-reported presence of pain or between cognitive functioning and self-reported pain experience.

Conclusions: Memory seems to be related to the self-reported presence of pain in adults with DS after explicit inquiry, although the clinical use of this model is yet limited. Therefore, further research is needed for insight into the role of cognitive processes in self-report (e.g., involving aspects such as acquiescence and repeated measurements) to evaluate whether neuropsychological examination could contribute to pain assessment in DS.

Original languageEnglish
Pages (from-to)1264-1277
Number of pages14
JournalPain medicine
Issue number7
Early online date15 Dec 2016
Publication statusPublished - Jul 2017


  • Clinical Significance
  • Cognitive Function
  • Down Syndrome
  • Pain Assessment


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