Association of Cognitive Impairment and Spinal Pain in the Older Adult Population in the United States: A Cross-Sectional Study.

Objective: The objective of this study was to explore the association between cognitive impairment and spinal pain in the older population in the United States.

Methods: We undertook a secondary analysis of cross-sectional data from the 1999 to 2000 and 2001 to 2002 National Health and Nutrition Examination Survey. The pooled data included a representative sample (n = 2975) of older adults (aged 60-85 years) in the United States. Cognitive impairment was assessed through the Digit Symbol Substitution Test. Spinal pain was defined with a multisite definition, including both nonspecific low back pain and neck pain present in the past 3 months. To account for the complex sampling design, logistic regression was performed using Taylor linearized variance estimation to compute weighted measures of associations.

Results: For older adults with spinal pain, the proportion of cognitive impairment increased with age, from 32.64% in the 60 to 64 age group to 93.83% in the 80 to 84 age group, which was also statistically significantly higher than the general population group and the group without spinal pain (P < .001). After controlling for demographic characteristics, socioeconomic status, and general health status, older adults with spinal pain had significantly increased odds of cognitive impairment (odds ratio 1.76, 95% confidence interval: 1.12, 2.79). Vulnerable subgroups (older, female, and less education) were identified.

Conclusion: There was a significant association between cognitive impairment and spinal pain in the older adult population in the United States. Within this population, there were vulnerable subgroups for which spinal pain and cognitive impairment had a greater impact, namely people who are older, female, and those with less education.