Abstract
Lumbar degenerative disease and dementia are increasing in super-aging societies and are both related to physical dysfunction and pain. However, the relationship between these diseases remains unclear. This cross-sectional study aimed to investigate the comorbidity rates of lumbar spinal canal stenosis (LSS) and mild cognitive impairment (MCI) and clarify the association between LSS presence, lumbar symptoms, and quality of life (QOL) related to low back pain and cognitive impairment in the Japanese population. We enrolled 336 participants (men 124; women 212; mean age 72.2 years) from a medical checkup program. LSS was diagnosed using a self-administered questionnaire, and lumbar symptoms were evaluated using the visual analog scale (low back pain, and pain and numbness of the lower limb). QOL related to low back pain was evaluated using the Japanese Orthopedic Association Back-Pain Evaluation Questionnaire (JOABPEQ: pain, and lumbar, and gait function). Radiological lumbar degeneration was classified using Kellgren-Lawrence grading and lateral radiographs of the lumbar spine. Cognitive function was measured using the Mini Mental State Examination (MMSE), and MCI was defined by a summary score of MMSE ≤27. Logistic and multiple linear regression analyses were performed to analyze the association between MCI, summary score of MMSE, and lumbar degenerative disease. The comorbidity rate of MCI and LSS was 2.1%, and the rate of MCI was 41% in participants with LSS. Lumbar function in JOABPEQ was associated with MCI. The presence of LSS and lumbar function in JOABPEQ were associated with MMSE. Over one-third of the people with LSS had MCI. The presence of LSS and deterioration of QOL due to low back pain were related to cognitive impairment. We recommend evaluating cognitive function for patients with LSS because the rate of MCI was high in LSS participants.
Highlights
Lumbar degenerative disease, such as lumbar spinal canal stenosis (LSS), degenerative spondylolisthesis, and spondylosis deformity, is more prevalent among middle-aged and elderly individuals
This study aimed to investigate the comorbidity rates of Mild cognitive impairment (MCI) and LSS by age and sex, and to clarify the relationship between MCI/ Mini Mental State Examination (MMSE) score and the factors related to lumbar degenerative disease—LSS presence, lumbar symptoms, quality of life (QOL) score depending on low back pain, and radiographical lumbar degeneration in a community-dwelling Japanese population
Number of men, and the prevalence of LSS and summed Kellgren-Lawrence grading were significantly higher in the MCI+ group than in the MCIgroup
Summary
Lumbar degenerative disease, such as lumbar spinal canal stenosis (LSS), degenerative spondylolisthesis, and spondylosis deformity, is more prevalent among middle-aged and elderly individuals. The number of people whose quality of life (QOL) is impaired by lumbar degenerative disease is expected to increase in a super-aging society; the proportion of older adults whose age is 65 years is over 21%. Mild cognitive impairment (MCI) is a pre-stage of dementia, and people with MCI are at high-risk for developing dementia [3]. MCI can be improved if risk factors of cognitive impairment are reduced [4, 5]. Reducing the risk of cognitive impairment is important to prevent the development of dementia. Several reports have shown that cognitive impairment is associated with pain and physical dysfunctions [6,7,8], which are the typical symptoms of musculoskeletal diseases. Cognitive function certainly deteriorates with age, thereby increasing the prevalence of MCI in the future
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