Brain predicted age difference mediates pain impact on physical performance in community dwelling middle to older aged adults

The purpose of the study was to examine associations between physical performance and brain aging in individuals with knee pain and whether the association between pain and physical performance is mediated by brain aging. Participants (n=202) with low impact knee pain (n=111), high impact knee pain (n=60) and pain-free controls (n=31) completed self-reported pain, magnetic resonance imaging (MRI), and a Short Physical Performance Battery (SPPB) that included balance, walking, and sit to stand tasks. Brain predicted age difference, calculated using machine learning from MRI images, significantly mediated the relationships between walking and knee pain impact (CI: -0.124; -0.013), walking and pain-severity (CI: -0.008; -0.001), total SPPB score and knee pain impact (CI: -0.232; -0.025), and total SPPB scores and pain-severity (CI: -0.019; -0.001). Brain-aging begins to explain the association between pain and physical performance, especially walking. This study supports the idea that a brain aging prediction can be calculated from shorter duration MRI sequences and possibly implemented in a clinical setting to be used to identify individuals with pain who are at risk for accelerated brain atrophy and increased likelihood of disability. (c) 2023 Elsevier Inc. All rights reserved.

Automated summary

The purpose of this study was to examine the association between physical performance and brain aging in individuals with knee pain and investigate whether pain and physical performance are mediated by brain aging. The results showed that brain aging significantly mediated the relationships between walking and knee pain impact, walking and pain-severity, total SPPB score and knee pain impact, and total SPPB scores and pain-severity. The study suggests that brain aging prediction can be calculated from shorter MRI sequences and potentially used to identify knee pain patients at risk for accelerated brain atrophy and increased disability.