Chronic Musculoskeletal Pain and the Occurrence of Falls in an Older Population

The objective of this study was to determine whether chronic musculoskeletal pain is associated with an increased occurrence of falls in a cohort of community-living older adults. The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston Study is a population-based longitudinal study of falls involving 749 adults aged 70 years and older. Participants recorded falls on monthly calendar postcards mailed to the study center during an 18-month period. There were 1029 falls reported during the follow-up. A report of 2 or more locations of musculoskeletal pain at baseline was associated with greater occurrence of falls. The age-adjusted rates of falls per person-year were 1.18  for the 300 participants with 2 or more sites of joint pain, 0.90 for the 181 participants with single-site pain, and 0.78  for the 267 participants with no joint pain. Similarly, more severe or disabling pain at baseline was associated with higher fall rates. The association persisted after adjusting for multiple confounders and fall risk factors. The greatest risk for falls was observed in persons who had 2 or more pain sites and those in the highest tertiles of pain severity and pain interference with activities compared with their peers with no pain or those in the lowest tertiles of pain scores.

Chronic pain measured according to number of locations, severity, or pain interference with daily activities was associated with greater risk of falls in older adults.

Suzanne G. Leveille; Richard N. Jones; Dan K. Kiely; Jeffrey M. Hausdorff; Robert H. Shmerling; Jack M. Guralnik,; Douglas P. Kiel; Lewis A. Lipsitz; Jonathan F. Bean. Chronic Musculoskeletal Pain and the Occurrence of Falls in an Older Population. JAMA. 2009;302(20):2214-2221.