Pain, cognitive impairment, and sarcopenia share common risk factors and neurophysiological processes, but studies investigating cognition and sarcopenia in older adults with pain are scarce. This study's main aim was to compare cognition and sarcopenia between older adults with and without chronic pain. A secondary aim was to investigate predictors of cognition and sarcopenia at baseline and 3 months while adjusting for confounders. Participants (67 older adults with pain and 67 asymptomatic older adults) were assessed for sociodemographic and clinical information, pain (number of painful body sites - body chart, pain phenotype - PainDETECT, severity and disability - BPI, pain catastrophizing - PCS, and kinesiophobia - Tampa Scale), cognition (MoCA), sarcopenia (risk of sarcopenia - SARC-F, hand grip strength, and calf circumference) and physical activity (RAPA) at baseline and 3 months after. Older adults with and without pain did not differ in cognition (Mean (95% CI): Pain = 21.47 (20.60
22.34)
Asymptomatic = 21.75 (20.89
22.61)), but older adults with pain had greater signs of sarcopenia than asymptomatic older adults, including higher risk of sarcopenia (Mean (95%CI): Pain=2.89 (2.41
3.37)
Asymptomatic=0.50 (0.32
0.68)) and lower hand grip strength (Pain=24.01 (21.74
26.29)
Asymptomatic=27.98 (25.80
30.16)). No between-group differences were found for calf circumference (Pain=35.03 (34.26
35.79)
Asymptomatic=34.55 (33.86
35.24)). Pain phenotype (baseline) and kinesiophobia (3 months) contributed to poorer cognition. Kinesiophobia and catastrophizing (baseline), and pain severity (3 months) contributed to sarcopenia. Despite no differences in cognition between older adults with and without pain, pain-related variables contributed to explaining sarcopenia and cognition. PERSPECTIVE: This study compared cognition and sarcopenia between older adults with and without pain and explored the association between pain, cognition, and sarcopenia. Groups were similar for cognition, but older adults with pain showed higher signs of sarcopenia. Kinesiophobia and pain severity partially explained cognition and sarcopenia among those with pain.