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Multisite pain linked to increased fall risk in older, community-dwelling patients
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Multisite pain is associated with an increased risk for falls among community-dwelling patients aged 50 years and older, according to recent findings in Arthritis Research & Therapy.
“Falls prevention guidelines are based upon management of known risk factors and are widely implemented by health care professionals, yet falls remain a common component of aging,” Victoria K. Welsh, MD, of Keele University, United Kingdom, and colleagues wrote. “Multisite pain, defined as pain in more than one part of the body, has been proposed as a novel risk factor for falls. A number of more recent studies have examined this; however, the subject remains under-investigated with comparatively small cohorts and consideration of limited putative confounders of the multisite pain and falls relationship.”
To bring together the published evidence and evaluate the link between multisite pain and fall risk, Welsh and colleagues conducted a search of 17 bibliographic databases from inception to December 2017. The researchers focused their search specifically on articles that studied community-dwelling adults aged 50 years or older, that included measures on multisite pain and fall information, and featured a no-pain group. Two reviewers screened the articles, conducted quality assessment and recorded data.
The search yielded 49,577 articles, 3,145 of which underwent abstract review. The researchers included 22 articles in their systematic review and 18 in the meta-analysis. Welsh and colleagues used random-effects meta-analysis to pool the effect estimate. In addition, they analyzed heterogeneity using I2, with a sensitivity analyses conducted via adjusted risk estimates and exclusively longitudinal studies.
According to the researchers, the unadjusted pooled OR for the association between patients reporting multisite pain and future fall risk was 1.82 (95% CI, 1.55-2.13). The adjusted pooled OR was 1.56 (95% CI, 1.39-1.74). According to Welsh and colleagues, multisite pain predicts future fall risk (OR=1.74; 95% CI, 1.57-1.93). In addition, in high-quality studies, participants who reported multisite pain had double the odds of a future fall compared with those who were pain-free.
“This systematic review and meta-analysis has found that multisite pain is associated with an increased risk of future self-reported fall,” Welsh and colleagues wrote. “Older people with multisite pain must therefore be considered at increased risk of falls. This is an important public health message to disseminate to older people who can self-identify with multisite pain and seek further guidance from health care professionals to reduce their risk of falls.”
The researchers added, “Health and social care professionals who are regularly reviewing older people are advised to identify those with multisite pain and signpost accordingly so that falls prevention management strategies can be implemented in line with current guidelines.” – by Jason Laday
Disclosure: Welsh reports no relevant financial disclosures. Please see the study for all other relevant financial disclosures.
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