The role of life-space mobility in the relationship of chronic low back pain characteristics with falls and cognitive impairment

Abstract

Chronic pain contributes to both physical and cognitive impairment, but the role of life-space mobility (LSM) in the pathway is unclear. We examined the cross-sectional association of pain with falls and mild cognitive impairment (MCI) and explored whether LSM mediates these associations in 279 Veterans (mean age=73.3±5.0y) in the Aging Back Clinics trial with chronic low back pain (CLBP). Data on pain characteristics, falls during the prior 3 months, Quick MCI screen, and Life-Space Assessment were collected. Logistic regression models showed that more severe pain was associated with greater odds of falls (OR=1.17, 95%CI=1.01-1.36), recurrent falls (OR=1.26, 95%CI=1.04-1.52), and MCI (OR=1.17, 95%CI=1.01-1.35), adjusting for sociodemographic and health characteristics. More pain interference was associated with greater odds of recurrent falls (OR=1.11, 95%CI=1.03-1.20). Structural equation modeling showed that LSM fully mediated the associations of pain severity and pain interference with MCI. Further longitudinal studies are needed to validate our findings.