Lumbar spinal stenosis is a risk factor for the development of dementia: locomotive syndrome and health outcomes in the Aizu cohort study

• Published in: European spine journal 2023-02, Vol.32 (2), p.488-494
• Main Authors: Kobayashi, Hiroshi, Tominaga, Ryoji, Otani, Koji, Sekiguchi, Miho, Nikaido, Takuya, Watanabe, Kazuyuki, Kato, Kinshi, Yabuki, Shoji, Konno, Shin-ichi
• Format: Article
• Language: English
• Subjects: Cohort analysis; Cohort Studies; Confidence intervals; Decision making; Dementia; Dementia - epidemiology; Dementia - etiology; Dementia disorders; Diabetes mellitus; Humans; Lumbar Vertebrae; Medicine; Medicine & Public Health; Musculoskeletal diseases; Neurosurgery; Original Article; Osteoarthritis; Outcome Assessment, Health Care; Prospective Studies; Risk Factors; Spinal stenosis; Spinal Stenosis - diagnosis; Spinal Stenosis - epidemiology; Surgical Orthopedics
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-022-07318-4

Purpose It remains unclear whether musculoskeletal diseases are risk factors for dementia development. This prospective cohort study of community-dwelling residents aimed to clarify the impact of lumbar spinal stenosis (LSS) on dementia development. Methods We included participants aged ≥ 65 years from the Locomotive Syndrome and Health Outcomes in the Aizu cohort study. LSS was diagnosed using the validated LSS diagnostic support tool. Dementia development between 2008 and 2015 was investigated using official long-term care insurance certification data. We analysed the effects of LSS on dementia development after adjusting for potential confounders, like age, sex, diabetes, depressive symptoms, hip and knee joint osteoarthritis, daily activity, and smoking habit. Results We included 1220 patients in the final analysis. The incidence of dementia was significantly higher in the LSS group [48 of 444 (10.8%)] than in the control group [34 of 776 (4.4%)]. Multivariable analysis using multiple imputations revealed that the confidence interval for the adjusted odds ratio of LSS for dementia development was 1.87 (95% confidence interval; 1.14–3.07). Conclusion We clarified that LSS is an independent risk factor for dementia development. Our findings suggest the importance of considering the risk of dementia in the decision-making process for the treatment of LSS.