As part of the MOBILIZE (Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly) Boston Study, researchers performed a prospective, longitudinal evaluation of 749 adults aged 70 years or older. Musculoskeletal pain was assessed at baseline and monthly during the 18-month follow up period using a 13-item joint pain questionnaire. Severity of pain and interference with daily activities were assessed with the Brief Pain Inventory. Findings were categorized as pain in 2 or more locations, pain in 1 location, or no pain. Subjects recorded falls on monthly calendars. A total of 1029 falls were reported during the 18-month study. The presence of chronic pain in 2 or more joints was significantly associated with greater occurrence of falls; the age-adjusted rate of falls per person-year was 1.18 (95% confidence interval [CI] 1.13-1.23) for pain in 2 or more sites compared to .90 (CI .87-.92) for 1 site, and .78 (CI .74-.81) for no joint pain (p<0.001 for 2 sites vs. no pain). The rate of falls was also significantly greater among patients in the highest tertile of pain severity (p<.05, highest vs. lowest tertile) and the highest tertile of pain interference with daily activities (p<.05, highest vs. lowest tertile) at baseline. This article reports the first prospective study to evaluate the impact of multiple pain sites on fall risk in community-dwelling older adults.
Leveille SG, Jones RN, Kiely DK, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009;302:2214-21.