# Addressing the chronic pain-early cognitive decline comorbidity among older adults; The Active Brains study

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $594,666

## Abstract

PROJECT SUMMARY
Chronic pain and early cognitive decline are increasingly prevalent among older adults, bidirectionally related, and
individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD). Chronic pain and cognitive
decline exacerbate each other, placing individuals on a “disability spiral” or worsened physical, emotional, and
cognitive functioning with incremental risk of ADRD. Currently there are no evidence-based treatments that successfully
address the chronic pain-early cognitive decline comorbidity among older adults. With funding from NCCIH and
NIA we used mixed methods to iteratively develop a multimodal, theory grounded, group-based mind-body activity
program tailored to the unique needs of older adults with chronic pain and early cognitive decline. The program helps
older adults manage pain, increase cognitive reserves, and increase engagement in activities that are meaningful to them
using quota-based pacing reinforced by a digital monitoring device. The program shows excellent feasibility and
acceptability for virtual delivery and remote data collection. Program participation is associated with improvement in
multimodal physical function (self-report, 6-minute walk test and Actigraph measured stepcount), emotional function
(depression and anxiety), cognitive function (self-report and objective), pain intensity and theory informed mediators.
Building on our promising study we now propose to conduct a fully powered RCT of our mind-body activity program
(Active Brains-Digital) versus an educational control (Health Enhancement Program) both delivered virtually among
N=260 older adults with musculoskeletal chronic pain and early cognitive decline. We will establish efficacy of Active
Brains-Digital, sustainability of improvement over 6 months, and mechanisms of change through relevant mediators and
moderators. The trial will take place at the Massachusetts General Hospital using our established methodology and
infrastructure. Active Brains-Digital has the potential to be the first evidence-based program for older adults with
chronic pain and early cognitive decline, with important implications for prevention of AD/ADRD in this high risk
population. This project directly aligns with NIA strategic Goal C, objectives 1 and 3.

## Key facts

- **NIH application ID:** 10767883
- **Project number:** 5R01AG075899-03
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Christine S Ritchie
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $594,666
- **Award type:** 5
- **Project period:** 2022-02-01 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10767883

## Citation

> US National Institutes of Health, RePORTER application 10767883, Addressing the chronic pain-early cognitive decline comorbidity among older adults; The Active Brains study (5R01AG075899-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10767883. Licensed CC0.

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