Abstract
BackgroundRecurrent falls represent a priority in geriatric research. In this study we evaluated the influence of pain as a risk factor for recurrent falls (two or more in 1 year) in the older (65–79 years) and oldest-old (80 or more years) non-institutionalized population.MethodsProspective cohort study. 772 non-institutionalized individuals with ages of 65 years or older (with overrepresentation of people aged 80 years or older [n = 550]) were included through randomized and multistage sampling, stratified according to gender, geographic area and habitat size. Basal evaluation at participant’s home including pain evaluation by Face Pain Scale (FPS, range 0–6) and then telephonic contact every 3 months were performed until complete 12 months. Multivariate analysis by logistic regression (recurrent falls as outcome variable) for each age group (older and oldest-old group) were developed considering pain as a quantitative variable (according to FPS score). Models were adjusted for age, gender, balance, muscle strength, depressive symptoms, cognitive decline, number of drugs and number of drugs with risk of falls.Results114 (51.35%) and 286 (52%) participants of older and oldest-old group, respectively, reported pain; and recurrent falls occurred in 6.93% (n = 12) of the older group and 12.06% (n = 51) of the oldest-old group. In the older group, pain was associated with recurrent falls, with an associated odds ratio (OR) of 1.47 (95% CI 1.08–2.00; beta 0.3864) for each unit increase in pain intensity (thus, participants with the most severe pain [FPS 6] had OR of 10.16 regarding to participants without pain [FPS 0]). In the oldest-old group, pain was not associated with recurrent falls.ConclusionsPain, a potentially modifiable and highly prevalent symptom, is a risk factor for recurrent falls in the older people (65–79 years). However, we have not been able to demonstrate that this relationship is maintained in the oldest-old population (80 or more years).
Highlights
Recurrent falls represent a priority in geriatric research
The objective of this study is to prospectively evaluate the influence of pain as a risk factor for recurrent falls in the older and oldest-old noninstitutionalized population
A total of 222 older participants and 550 oldest-old participants were included. 630 (81.6%) participants (207 older and 423 oldest-old participants) completed the 12-month follow-up, with the mean follow-up time of 11.85 months for the older group and 11.29 months (SD 2.01) for the oldest-old group. 1 older and 30 oldest-old participants died during the follow-up period
Summary
Recurrent falls represent a priority in geriatric research. In this study we evaluated the influence of pain as a risk factor for recurrent falls (two or more in 1 year) in the older (65–79 years) and oldest-old (80 or more years) non-institutionalized population. The net benefit of this approach is considered small at the population scale [7]; the identification of new risk factors that are still not known or not confirmed represents a care priority. In this sense, pain as a risk factor for recurrent falls is relevant because it is a highly prevalent (25–75% of the older population) [8] and potentially modifiable factor. A positive association was reported in an autonomous male population (unassisted ambulation) [13], as well as a positive relationship for lumbar pain [14, 15]
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