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Purpose <p>To explore how pain catastrophizing affects cognitive frailty in patients with lumbar disc herniation, and to analyze the mediating roles of sleep quality and the mitigating effect of emotional adaptability.</p> Methods <p>This was a retrospective study conducted from July 2023 to August 2024, including 120 lumbar disc herniation patients that were divided into the cognitive frailty group (34 cases) and the non-cognitive frailty group (86 cases). Binary Logistic regression was used to screen the factors influencing cognitive frailty. Mediation and mitigation analyses were conducted using the Process model. The mediating effect of sleep quality (scored by the athens insomnia scale (AIS)) was tested using the Process model, while the mitigating effect of emotional adaptability (scored by the emotion regulation questionnaire (ERQ)) was examined through hierarchical regression analysis. Pain catastrophizing was measured using the pain catastrophizing scale (PCS).</p> Results <p>There were significant differences in age, medication types, sleep quality, pain catastrophizing, and emotional adaptability between the two groups (<i>P</i> &lt; 0.05). Logistic regression data showed that age (<i>P</i> = 0.007), type of medication (<i>P</i> = 0.003), pain catastrophizing (<i>P</i> = 0.001), sleep quality (<i>P</i> = 0.011), and emotional adaptability (<i>P</i> = 0.003) were independent risk factors for cognitive frailty. Sleep quality played a partial mediating role between pain catastrophizing and cognitive frailty (mediating effect 10.92%). Emotional adaptability had a significant mitigating effect on the relationship between pain catastrophizing and cognitive frailty (interaction term <i>P</i> = 0.049), with stronger adaptability weakening the predictive effect of pain catastrophizing.</p> Conclusion <p>Pain catastrophizing can affect cognitive frailty directly or through the mediating pathways of sleep quality. Thus, attention should be paid to psychological pain management, sleep improvement and emotional regulation in clinical practice to reduce the risk of cognitive weakness.</p>

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The relationship between pain catastrophizing and cognitive frailty in patients with lumbar disc herniation mediated by sleep quality: the regulatory effect of emotions— a retrospective study

  • 期刊论文

  • 发表日期：

    2025年10月13日

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  • Dengxi Luo,
  • Wan Ching Wong,
  • Zhao Li,
  • Guangyang Qin,
  • Zhoufeng Lan,
  • Fengcheng Mo,
  • Yongan Wei

摘要

Purpose

To explore how pain catastrophizing affects cognitive frailty in patients with lumbar disc herniation, and to analyze the mediating roles of sleep quality and the mitigating effect of emotional adaptability.

Methods

This was a retrospective study conducted from July 2023 to August 2024, including 120 lumbar disc herniation patients that were divided into the cognitive frailty group (34 cases) and the non-cognitive frailty group (86 cases). Binary Logistic regression was used to screen the factors influencing cognitive frailty. Mediation and mitigation analyses were conducted using the Process model. The mediating effect of sleep quality (scored by the athens insomnia scale (AIS)) was tested using the Process model, while the mitigating effect of emotional adaptability (scored by the emotion regulation questionnaire (ERQ)) was examined through hierarchical regression analysis. Pain catastrophizing was measured using the pain catastrophizing scale (PCS).

Results

There were significant differences in age, medication types, sleep quality, pain catastrophizing, and emotional adaptability between the two groups (P < 0.05). Logistic regression data showed that age (P = 0.007), type of medication (P = 0.003), pain catastrophizing (P = 0.001), sleep quality (P = 0.011), and emotional adaptability (P = 0.003) were independent risk factors for cognitive frailty. Sleep quality played a partial mediating role between pain catastrophizing and cognitive frailty (mediating effect 10.92%). Emotional adaptability had a significant mitigating effect on the relationship between pain catastrophizing and cognitive frailty (interaction term P = 0.049), with stronger adaptability weakening the predictive effect of pain catastrophizing.

Conclusion

Pain catastrophizing can affect cognitive frailty directly or through the mediating pathways of sleep quality. Thus, attention should be paid to psychological pain management, sleep improvement and emotional regulation in clinical practice to reduce the risk of cognitive weakness.