• Saliu A Balogun, Velandai Srikanth, LeeuwGuusje van derGVDepartment of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., and Michele L Callisaya.
• Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
• Intern Med J. 2023 Apr 1; 53 (4): 503509503-509.

BackgroundPain at multiple sites is prevalent among older people. However, studies investigating the relationship between pain and falls focus largely on single-site pain.AimTo examine the association between pain at multiple sites and falls among community-dwelling older Australians.MethodsParticipants aged >60 years were randomly selected from the electoral roll. Falls were recorded prospectively over 12 months. Pain at multiple sites was assessed using a questionnaire. The total number of painful sites was calculated. Widespread pain was defined as pain in the upper limb, lower limb and in the axial skeletal region, with moderate to severe pain in at least one region. Log multinomial regression, with adjustment for confounders, was used to estimate whether widespread pain or number of painful sites increased the risk of a single (one fall) and multiple falls (≥2 falls).ResultsThere were 299 participants (43% women; mean age 72 ± 7.0 years). The mean (standard deviation) of falls was 0.8 ± 1.5. The frequencies of single and multiple falls were 23% (n = 68) and 16% (n = 49) respectively. A higher number of painful sites was associated with an elevated risk of a single fall (relative risk (RR) = 1.08; 95% confidence interval (CI): 0.96-1.27) and multiple falls (RR = 1.20; 95% CI: 1.02-1.41). However, the risk of multiple, but not single fall was substantial and statistically significant. Furthermore, compared with those without pain, individuals with widespread pain had an elevated risk of single (RR = 1.87; 95% CI: 0.80-5.09) and multiple falls (RR = 3.94; 95% CI: 1.15-13.51). However, the magnitude of effects of single fall was smaller and not statistically significant.ConclusionsFalls risk should be ascertained for older people with pain, irrespective of whether they present with a single or multiple sites pain. Nevertheless, older adults with multisite pain may require additional attention as they appear to have a significantly elevated risk of multiple falls.© 2021 Royal Australasian College of Physicians.

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