Cognitive dysfunction in patients over 60 with non- specific chronic low back pain: A cross-sectional study

Abstract

Background: Although few studies in recent years have indicated a relationship between chronic low back pain (CLBP) and cognitive impairment, clear evidence is lacking, emphasizing the need for further research in this area. This study aimed to investigate the frequency of cognitive dysfunction and associated factors in patients over 60 with non-specific CLBP.

Methods: A total of 107 consecutive participants, including 57 patients with nonspecific CLBP and 50 healthy controls matched for age, sex, and education, were enrolled in this prospective, cross-sectional, controlled study. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and the Standard Mini- Mental Test (SMMT). Pain and fatigue severity was measured using the Visual Analog Scale (VAS), while depression, pain catastrophizing, functional disability, and quality of life were evaluated using the Beck Depression Inventory (BDI), Pain Catastrophizing Scale (PCS), Roland Morris Disability Questionnaire (RMDQ), and the Short Form-36 (SF-36) respectively.

Results: The CLBP group showed significantly lower cognitive performance than the control group (p < 0.001). Significant impairments were observed in visuospatial abilities, attention, and executive functions. Beck Depression Inventory, PCS, and RMDQ scores were significantly higher in the CLBP group (p < 0.001), while SF-36 scores and sleep quality were notably lower (p < 0.001 for all).

Conclusions: Chronic low back pain patients exhibit significant cognitive impairments, higher levels of depression, pain catastrophizing, and functional disability, along with a lower quality of life. These findings emphasize the importance of incorporating cognitive and psychological evaluations into the multidisciplinary management of CLBP. Clinicaltrials.gov identifier: NCT06278467