Cognitive Dysfunction in Fibromyalgia: Prevalence and Implications for Clinical Practice

A MoCA-based case-control study found that cognitive dysfunction is common in fibromyalgia and is associated with reduced daily function.

This cross-sectional case-control assessment enrolled 47 female patients with fibromyalgia and 19 matched healthy controls and used the Montreal Cognitive Assessment with a cutoff of <26 to define impairment. Cognitive dysfunction was found in 72.3% of patients with fibromyalgia vs. 5.3% of controls.

MoCA scores inversely correlated with pain (r = −0.34, p = 0.02), depression (r = −0.48, p = 0.01) and sleep disturbance (r = −0.48, p < 0.01), and showed a strong positive association with quality of life (ρ = 0.60, p < 0.001). Together, these findings link cognitive performance to multiple symptom domains in fibromyalgia.

In multivariate models, higher fibromyalgia impact (FIQ‑P) remained independently associated with cognitive dysfunction (adjusted OR 1.18, 95% CI 1.06–1.30, p < 0.01). Pain severity (adjusted B = −0.40; 95% CI −0.64 to −0.15; p < 0.01) and depressive symptoms (adjusted B = −2.60; 95% CI −4.12 to −1.04; p = 0.001) each independently predicted lower MoCA scores.

The evidence supports systematic cognitive screening in routine fibromyalgia assessment and integrating cognitive concerns into multidisciplinary care pathways.