Fibromyalgia is typically characterized by widespread pain and is present in around 0.5-10% of worldwide population with a seven times higher presence among females than males.
Apart from pain there are symptoms of fatigue, sleep disorders, stiffness, headaches, irritable bowel syndrome, memory or concentration problems etc.
Fibromyalgia and cognitive dysfunction
Studies have shown that over 50% of patients with fibromyalgia suffer from mental confusion and decline of memory and mental faculties.
Mental confusion along with difficulty in concentration and loss of memory is often termed “fibro fog”. These features are termed cognitive dysfunction and include common manifestations such as:-
- forgetfulness and memory problems - tests reveal that the memory components affected include impaired working memory, episodic memory and semantic memory -they have a poorer free recall
- concentration difficulties and attention problems
- poorer verbal fluency and verbal knowledge
- difficulty in focussing
- impaired judgement
- impaired ability to perform simple cognitive tasks
- slowed or altered speech and other speech problems
There are studies that have compared the cognitive skills and abilities of fibromyalgia patients with healthy controls of similar age and educational status.
Results showed that fibromyalgia patients performed worse than their healthy counterparts but had intact speed of information processing.
When the fibromyalgia patients were compared to healthy adults 20 years older, it was noted that although the fibromyalgia patients had intact information processing, they had poorer verbal knowledge than older adults.
Assessing cognitive skills
Cognitive skills and memory functions should be routinely assessed while evaluating a case of fibromyalgia according to all leading recommendations and guidelines for diagnosis and management of fibromyalgia.
Cognitive dysfunction may occur uniformly among all fibromyalgia patients irrespective of their age, pain severity or the presence of anxiety or depressive symptoms.
Patients with cognitive impairment also commonly have symptoms of anxiety and depression.
Further pain severity is an indicator or predictor of level of cognitive impairment. Measures of depression, anxiety and other factors do not influence the level of cognitive decline.