Background/Purpose: The issue of progressive decline in cognitive abilities is a source of concern to many patients with fibromyalgia.  The fear of progressing from fibrofog in middle age  to Alzheimer’s or other forms of dementia is central to the worries shared by many.  To determine if cognitive impairment progresses over time in fibromyalgia, a cross sectional study of cognitive functioning was conducted with a battery of neuro-cognitive tests known to be sensitive to cognitive change. 

Methods: In a cross-sectional study, cognitive disparities on 14 neurocognitive measures were evaluated in two cohorts of fibromyalgia subjects who met the new criteria for fibromyalgia.   The first cohort contained 69 subjects with a short duration of cognitive problems (12 months or less).  The second cohort contained 39 subjects with a long duration of cognitive problems (≥ 84 months or greater). 

Results: The two groups were similar in terms of mean (±SE) education (15.0±2.2 vs. 14.9±2.5), Vocabulary Scale score (11.2 ± 2.3 vs. 11.9 ± 2.8), and depression  (17.5±9.4 vs. 17.8±9.3).   The Long Duration Cohort was significantly older (45.6 ± 10.8 vs. 52.3± 9.1 years; p<0.001).  Cognitive data of the two cohorts are displayed in Table 1.  No significant differences were found between the two duration derived cohorts on 13 of the 14 cognitive measures.  Performance declined with the duration of cognitive problems on Trails A, a measure of spatial scanning and cognitive sequencing.  However, the skills of Trails A are incorporated inTrails B, where performance of the two groups was essentially equivalent.  Measures of episodic memory and processing speed, markers of preclinical Alzheimer’s disease, are in the normal range for both cohorts

Conclusion: Fibromyalgia patients’ fear of developing Alzheimer’s or other forms of dementia was not borne out by the data. Duration of cognitive problems was not a determiner of cognitive severity. People with a duration of 84 months or greater were not significantly more cognitively disabled than those with a duration of 12 months or less. The data do not support later transitions to dementia.  The fact that individuals suffering cognitive dysfunction from 7 to 26 years did not exhibit a broad based deficit relative to those suffering cognitive dysfunction for a duration of a year of less should allay the worries of many with fibromyalgia who fear that fibrofog in the middle years is the start of a dementing process. .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cross-sectional-neurocognitive-data-do-not-support-a-transition-from-fibrofog-to-alzheimers-disease-in-fibromyalgia-patients/