Cognition is selectively impaired in males with spinal pain: A retrospective analysis of data from the Longitudinal Study of Ageing Danish Twins

Cognitive decline and spinal pain (back pain [BP] and neck pain [NP]) represent a major public health challenge, yet the potential relationship between them remains elusive. A retrospective analysis of the Longitudinal Study of Aging Danish Twins was performed to determine any potential relationships between BP/NP and cognitive function adjusting for age, sex, educational and socioeconomic status. A total of 4,731 adults (2,788 females/1,943 males) aged 78±6 (SD) years were included in the analysis. We observed a one-month prevalence of 25% with BP, 21% with NP and 11% for combined BP/NP. While there were no differences in cognition scores for male and females reporting combined BP/NP, compared to those without combined BP/NP (34.38 points; 95% confidence interval (CI) =31.88, 36.88 vs 35.72 points; 95% CI=35.19, 36.26; P=0.180; and 35.72 points; 95% CI=35.19, 36.26 vs 35.85 points; 95% CI=35.39, 36.31; P=0.327, for male and females respectively), an adjusted analysis revealed that males with combined BP/NP presented with lower cognitive scores compared to males without combined BP/ NP (81.26 points; 95% CI=73.80, 88.72 vs 79.48 points; 95% CI=70.31, 88.66; P=0.043). The findings of this hypothesis-generating study may highlight a potential sex-specific association between spinal pain and later-life neurodegeneration.