Multisite pain and self-reported falls in older people: systematic review and meta-analysis

Welsh, Victoria; Clarson, Lorna; Mallen, Christian; McBeth, John

doi:10.1186/s13075-019-1847-5

Cited by 41 publications

(50 citation statements)

References 26 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This has been further supported by recent findings from prospective studies . In addition, the associations appear to be more pronounced with an increasing number of painful sites . Pain has also been shown to be associated with BMD, but results are mixed with some reporting positive and some negative associations .…”

Section: Introductionsupporting

confidence: 61%

“…A link between pain and risk of falls has been documented in prior as well as recent studies. Further, risk for falls was more pronounced with increasing number of painful sites . It has been postulated that the increased risk of falls is because of local joint pathology, leg muscle weakness, or slowed neuromuscular responses, and cognitive and executive function .…”

Section: Discussionmentioning

confidence: 99%

“…Further, risk for falls was more pronounced with increasing number of painful sites. (26,27) It has been postulated that the increased risk of falls is because of…”

Section: Discussionmentioning

confidence: 99%

“…(21)(22)(23)(24)(25) In addition, the associations appear to be more pronounced with an increasing number of painful sites. (26,27) Pain has also been shown to be associated with BMD, but results are mixed with some reporting positive and some negative associations. (28)(29)(30) This has led to several investigations of whether an increased risk for falls and/or changed BMD associated with pain translates into an increased risk of fractures; however, these studies have focused on single-site pain with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pain at Multiple Sites Is Associated With Prevalent and Incident Fractures in Older Adults

Pan

Tian

Aitken

et al. 2019

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Musculoskeletal pain is common and typically occurs at multiple sites. Pain has been shown to be associated with falls risk; however, whether an increased risk for falls associated with multisite pain (MSP) translates into an increased risk of fractures has not been investigated. This study aimed to examine the association of number of painful sites with prevalent and incident fractures. Data from a longitudinal population‐based study of older adults (mean age 63 years) were utilized. Follow‐up was performed at 2.6, 5.1, and 10.7 years later, respectively. Presence/absence of pain at the neck, back, hands, shoulders, hips, knees, and feet was assessed by questionnaire at baseline. Participants were classified into three groups according to the total number of painful sites: zero to two, three to four, and five to seven. Fractures were self‐reported at each time point. BMD was measured by DXA. Falls risk was calculated based on the Short‐Form Physiological Profile Assessment. Log‐binomial regression was used for the analyses. There were 450 fractures at baseline and 154 new fractures reported during a mean follow‐up period of 10.7 years (range 9.2 to 12.5 years). In multivariable analyses, number of painful sites was associated with prevalent fractures at any and nonvertebral site. Furthermore, participants with five to seven painful sites had an increased risk of incident fractures at any site (RR 1.69; 95% CI, 1.13 to 2.53); major site, including the femur, radius, ulnar, vertebral, rib, and humerus (RR 2.17; 95% CI 1.12 to 4.22); and vertebral site (RR 6.44, 95% CI, 1.64 to 25.33) compared with those with pain at zero to two sites. These associations remained statistically significant after further adjustment for falls risk and BMD. Pain at multiple sites was associated with incident fracture risk in a dose‐response manner, suggesting that widespread pain is an independent contributor to fracture risk. The potential for pain management in fracture prevention warrants further exploration. © 2019 American Society for Bone and Mineral Research.

show abstract

Section: Introductionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

“…Further, risk for falls was more pronounced with increasing number of painful sites. (26,27) It has been postulated that the increased risk of falls is because of…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pain at Multiple Sites Is Associated With Prevalent and Incident Fractures in Older Adults

Pan

Tian

Aitken

et al. 2019

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…Covariates were selected following a literature review of falls risk factors and consideration of covariates that had been included in publications identified in a systematic review and meta-analysis investigating multisite pain and falls [21]. The details of the health survey used in the NorStOP cohort studies have been published previously [13].…”

Section: Methodsmentioning

confidence: 99%

Investigating multisite pain as a predictor of self-reported falls and falls requiring health care use in an older population: A prospective cohort study

et al. 2019

Self Cite

View full text Add to dashboard Cite

Older people are continuing to fall despite fall prevention guidelines targeting known falls’ risk factors. Multisite pain is a potential novel falls’ risk factor requiring further exploration. This study hypothesises that: (1) an increasing number of pain sites and widespread pain predicts self-reported falls and falls recorded in primary and secondary healthcare records; (2) those relationships are independent of known falls’ risk factors and putative confounders. This prospective cohort study linked data from self-completed questionnaires, primary care electronic health records, secondary care admission statistics and national mortality data. Between 2002–2005, self-completion questionnaires were mailed to community-dwelling individuals aged 50 years and older registered with one of eight general practices in North Staffordshire, UK(n = 26,129) yielding 18,497 respondents. 11,375 respondents entered the study; 4386 completed six year follow-up. Self-reported falls were extracted from three and six year follow-up questionnaires. Falls requiring healthcare were extracted from routinely collected primary and secondary healthcare data. Increasing number of pain sites increased odds of future 3 year (odds ratio 1.12 (95% confidence interval: 1.01–1.24)) and 6 year self-reported fall (odds ratio 1.02 (1.00–1.03)) and increased hazard of future fall requiring primary healthcare (hazard ratio 1.01 (1.00–1.03)). The presence of widespread pain increased odds of future 3 year (odds ratio 1.27 (0.92–1.75)) and 6 year fall (odds ratio 1.43(1.06–1.95)) and increased hazard of future fall requiring primary healthcare (hazard ratio 1.27(0.98–1.65)). Multisite pain was not associated with future fall requiring secondary care admission. Multisite pain must be included as a falls’ risk factor in guidelines to ensure clinicians identify their older patients at risk of falls and employ timely implementation of current falls prevention strategies.

show abstract

Low Back Pain as a Risk Factor for Recurrent Falls in People With Knee Osteoarthritis

Iijima

Shimoura

Aoyama

et al. 2021

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. Knee osteoarthritis (OA) has been suggested to increase the risk of falls. Low back pain (LBP) is a potential risk factor for falls in people with knee OA, but this issue has not been addressed adequately in previous studies. The objective of this study was to investigate the relationship between LBP and falls in people with knee OA in a 12-month period. Methods. Participants with knee OA (Kellgren/Lawrence [K/L] grade ≥1) completed questionnaires for LBP and falls that occurred in the preceding 12 months. Binary and ordinal logistic regression analyses were performed to assess the relationship between LBP or moderate-to-severe LBP (numeric rating scale ≥4 points) and any fall (≥1 fall) or recurrent falls (≥2 falls) after adjustment for age, sex, K/L grade, knee pain severity, and quadriceps strength. Sensitivity analyses were performed excluding people with sciatica, nonchronic LBP, K/L grade 1, and those receiving pain medications. Results. We included 189 participants (ages 61-90 years, 78.3% women) in this study. Of these participants, 41 (21.6%) reported falls in the preceding 12 months. People with any LBP (n = 101) and those with moderate-to-severe LBP (n = 45) had 2.7-and 3.7-times higher odds of recurrent falls, respectively. Sensitivity analyses revealed a strong correlation between moderate-to-severe LBP and recurrent falls. Conclusion. Thorough investigation of LBP as a risk factor for recurrent falls in people with knee OA may provide a novel insight into the pathomechanics of recurrent falls in this population.

show abstract

Multisite pain and self-reported falls in older people: systematic review and meta-analysis

Cited by 41 publications

References 26 publications

Pain at Multiple Sites Is Associated With Prevalent and Incident Fractures in Older Adults

Pain at Multiple Sites Is Associated With Prevalent and Incident Fractures in Older Adults

Investigating multisite pain as a predictor of self-reported falls and falls requiring health care use in an older population: A prospective cohort study

Low Back Pain as a Risk Factor for Recurrent Falls in People With Knee Osteoarthritis

Contact Info

Product

Resources

About