Citation

Stubbs B, Eggermont L, Binnekade T, Sephery A, Patchay S, Schofield SP. Arch. Phys. Med. Rehabil. 2014; 95(1): 175-187.e9.

Affiliation

Physiotherapist, PhD candidate, School of Health and Social Care, University of Greenwich, London, United Kingdom. Electronic address: b.stubbs@greenwich.ac.uk.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2013.08.241

PMID

24036161

Abstract

OBJECTIVE: To conduct a systematic review and meta-analysis to establish the association between pain and falls in community dwelling older adults. DATA SOURCES: Electronic databases from inception until 1(st) March 2013 including Cochrane Library, CINAHL, EBSCO, EMBASE, PubMed and PsycINFO. STUDY SELECTION: Two reviewers independently conducted the searches and completed methodological assessment of all included studies. Studies were included that (a) focussed on older adults over 60 years old, (b) recorded falls over 6 or more months, (c) identified a group with and without pain. Studies were excluded that (d) included participants with dementia, a neurological condition (e.g. stroke), (e) participants whose pain was caused by a previous fall, (f) individuals with surgery/ fractures in the past 6 months. DATA EXTRACTION: One author extracted all data and this was independently validated by another author. DATA SYNTHESIS: 1,334 articles were screened and 21 studies met the eligibility criteria. 50.5% of older adults with pain reported one or more fall over 12 months compared to 25.7% of controls (p<0.001). A global meta-analysis with 14 studies (n=17,926) demonstrated that pain was associated with an increased odds of falling (OR: 1.56, 95% Confidence Interval (CI): 1.36 to 1.79, I(2)=53%). A subgroup meta-analysis incorporating studies that monitored falls prospectively established that the odds of falling was significantly higher in those with pain (n=4,674; OR: 1.71, CI: 1.48 to 1.98, I(2)=0%). Foot pain was strongly associated with falls (n=691; OR: 2.38, CI: 1.62 to 3.48, I(2)=8%) as was chronic pain (n= 5,367; OR 1.80, CI: 1.56 to 2.09, I(2)=0%). CONCLUSION: Community dwelling older adults with pain were more likely to have fallen in the past 12 months and fall again in the future. Foot and chronic pain were particularly strong risk factors for falls and clinicians should routinely enquire about these when completing falls risk assessments.

Language: en