Special Poster Session 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

The causal association between chronic back pain and accelerated cognitive decline in older adults: big data analysis from four databases (115642)

Arnold Wong 1 , Frank Fan Huang 1 , Daniel KY Zheng 1 , Manuela Ferreira 2 , Dino Samartzis 3 , Paulo Ferreira 4
  1. The Hong Kong Polytechnic University, Hung Horn, HONG KONG, Hong Kong
  2. George Institute for Global Health, Sydney, Australia
  3. Rush University Medical Center, Chicago, The United States
  4. The University of Sydney, Sydney

INTRODUCTION

Recent research indicates that chronic back pain (CBP) is linked to more severe cognitive decline in older adults. However, the longitudinal relationships between these factors across different regions remain unclear. This study aimed to investigate the long-term causal association between CBP and accelerated cognitive decline in older adults, utilizing data from four major databases.

METHODS

We pooled data from the China Health and Retirement Longitudinal Study, the English Longitudinal Study of Ageing, the Health and Retirement Study, and the Survey of Health, Ageing, and Retirement in Europe, which encompasses 17 countries. CBP and cognitive function data were extracted for individuals aged 60 and above at baseline, excluding those with dementia. We employed separate logistic regression models to examine the longitudinal association between CBP and cognitive outcomes, adjusting for the minimal sufficient adjustment set. Statistical significance was defined as P<0.05P < 0.05P<0.05.

RESULTS

The analysis included 20,448 individuals followed between 2010 and 2023, with a median follow-up of 8.4 years. The adjusted model revealed that CBP was associated with an increased incidence of subjective cognitive decline or dementia in Europe and the US, as well as cognitive decline in England. CBP was significantly linked to poorer cognitive performance, including numeracy, orientation, word recall memory, and overall cognitive scores among individuals in England and Europe, with the exception of orientation in England. In the US and China, CBP was associated with numeracy and orientation, respectively.

DISCUSSION

This study is the first to demonstrate that chronic back pain (CBP) significantly increases the risk of subjective cognitive decline, memory-related diseases, and impairments across various cognitive domains in older adults. Given the aging population and the high prevalence of CBP in this demographic, it is essential for clinicians to empower older adults with CBP to actively manage their pain and monitor their cognitive health.