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

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.