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Pain and Spine Medicine

Dementia Risk Following Gabapentin Prescription in Chronic Pain Patients

Friday, October 24, 2025
9:15 AM - 10:30 AM MT
Location: Session Room - 250 DEF

    Poster Presenter(s)

  • Nafis Eghrari, Other

    Medical Student
    Case Western Reserve University School of Medicine
    Cleveland, Ohio

    • Co-Author(s)

  • IY

    Isabella Yazji, Other

    Medical Student
    Case Western Reserve University School of Medicine
    Cleveland, Ohio

  • Bryan Yavari, Other

    Medical Student
    University of Arizona College of Medicine - Phoenix
    Scottsdale, Arizona

  • Chong Kim, MD

    Professor
    MetroHealth/Case Western Reserve University
    Westlake, Ohio

Disclosure(s):
Nafis Eghrari, Other: No financial relationships to disclose
Bryan Yavari, Other: No financial relationships to disclose
Chong Kim, MD: No financial relationships to disclose
Background and/or Objectives: Gabapentin is a popular medication for managing chronic pain. Current literature has indicated a potential association between dementia incidence and gabapentin; however, this relationship has not been well-investigated. The current study aimed to assess the incidence of dementia within 10 years following gabapentin prescription in patients with chronic pain.

Design: Retrospective cohort study.

Setting : National database.

Participants : TriNetX, a national research network of de-identified patient records, was retrospectively queried. Adult patients diagnosed with chronic pain, chronic pain syndrome, lumbar radiculopathy, chronic low back pain, or fibromyalgia were identified through ICD-10 codes. In total, 1,763,148 patients were included in our analysis.

Interventions: not applicable

Main Outcome Measures: Incidence of dementia and mild cognitive impairment within 10 years of pain diagnosis in patients prescribed versus not prescribed gabapentin following diagnosis.

Results: Our analysis involved 507,822 patients following propensity-score matching. There was no difference in dementia incidence between elderly patients (age >65) prescribed versus not prescribed gabapentin. Non-elderly adult patients (age 18-64) prescribed gabapentin were more likely to develop dementia versus those not prescribed gabapentin (OR: 1.53; 95% CI: 1.35–1.72). The largest difference in neurocognitive decline following gabapentin prescription was in the 18-34 age group, where patients prescribed gabapentin were over 2.3x likely to develop dementia (OR: 2.34; 95% CI: 1.19–4.60) and over 3.3x likely to experience mild cognitive impairment (OR: 3.36; 95% CI: 1.96–5.78) compared to patients with no gabapentin prescription.

Conclusions: Gabapentin prescription in non-elderly adults with chronic pain is associated with an increased risk of dementia and cognitive impairment, with the largest associated risk in young adult patients. Physicians managing patients with chronic pain should closely monitor younger patients who are prescribed gabapentin.