Older adults with chronic musculoskeletal pain are at increased risk of recurrent falls and the brief pain inventory could help identify those most at risk

Brendon Stubbs*, Laura Eggermont, Sandhi Patchay, Pat Schofield

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

<jats:sec><jats:title>Aim</jats:title><jats:p>Chronic musculoskeletal pain (<jats:styled-content style="fixed-case">CMP</jats:styled-content>) and falls are common among community‐dwelling older adults. The study aims were: (i) to investigate the relationship between <jats:styled-content style="fixed-case">CMP</jats:styled-content> and any falls (≥1), single falls and recurrent falls (≥2) in community‐dwelling older adults; and (ii) to determine the discriminative validity of the Brief Pain Inventory (<jats:styled-content style="fixed-case">BPI</jats:styled-content>) to differentiate between non‐fallers and (a) any and (b) recurrent fallers.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A cross‐sectional study involving 295 community‐dwelling participants (mean age 77.5 ± 8.1 years, 66.4% female) was carried out. <jats:styled-content style="fixed-case">CMP</jats:styled-content> was assessed and classified as none (comparison group), single and multisite (≥2). The <jats:styled-content style="fixed-case">BPI</jats:styled-content> severity and interference subscales were used, and falls were recorded over 12 months. Data were analyzed with logistic regression and receiver operating characteristic curves (<jats:styled-content style="fixed-case">ROC</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Over half of the participants (154/295, 52.2%) had <jats:styled-content style="fixed-case">CMP</jats:styled-content> (41.6% single and 58.4% multisite pain). Participants with <jats:styled-content style="fixed-case">CMP</jats:styled-content> were at increased risk of recurrent falls (<jats:styled-content style="fixed-case">OR</jats:styled-content> 2.25, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.03–4.88), and this risk was highest in those with multisite <jats:styled-content style="fixed-case">CMP</jats:styled-content> (<jats:styled-content style="fixed-case">OR</jats:styled-content> 3.43, <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.34–8.65). The <jats:styled-content style="fixed-case">BPI</jats:styled-content> severity subscale showed good discriminative ability to differentiate between recurrent and non‐fallers with an area under the curve (<jats:styled-content style="fixed-case">AUC</jats:styled-content>) of 0.731 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.635–0.826); a mean score of 5.1 had a sensitivity of 93.3% and specificity of 56.7%. The <jats:styled-content style="fixed-case">AUC</jats:styled-content> for the <jats:styled-content style="fixed-case">BPI</jats:styled-content> interference subscale was 0.724 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.630–0.818), and a cut‐off score of 4.6 had a sensitivity of 84.4% and specificity of 57.8%</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Older adults with multisite <jats:styled-content style="fixed-case">CMP</jats:styled-content> are at greatest risk of recurrent falls. In clinical settings, the <jats:styled-content style="fixed-case">BPI</jats:styled-content> could prove useful to discriminate between recurrent and non‐fallers. <jats:bold>Geriatr Gerontol Int 2015; 15: 881–888.</jats:bold></jats:p></jats:sec>
Original languageEnglish
Pages (from-to)881-888
Number of pages0
JournalGeriatrics &amp; Gerontology International
Volume15
Issue number7
Early online date28 Aug 2014
DOIs
Publication statusPublished - Jul 2015

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