Background Chronic pain is a risk factor contributing to mobility impairment and falls in older adults. Little is known about the patterns of circumstances of falls among older adults with chronicpain. Objective To examine the relationship between chronic pain and circumstances of falls including location, activities at the time of falls and self-reported causes of falls in older adults. Design Prospective cohort study. Setting Communities in/around Boston, Massachusetts. Subjects The MOBILIZE Boston Study enrolled 765 adults aged ≥70 years. Methods Pain severity, fall occurrence and fall circumstances were recorded using monthly calendar postcards and fall follow-up interviews during a 4-year follow-up period. Generalised estimating equation models were performed to examine the relation between monthly pain ratings and circumstances of the first fall in the subsequent month. Results Compared to fallers without chronic pain, fallers with moderate-to-severe pain had around twice the likelihood of reporting indoor falls (aOR = 1.93, 95%CI: 1.32–2.83), falls in living or dining rooms (aOR = 2.06, 95%CI: 1.27–3.36), and falls due to health problems (aOR = 2.08, 95%CI: 1.16–3.74) or feeling dizzy or faint (aOR = 2.10, 95%CI: 1.08–4.11), but they were less likely to report falls while going down stairs (aOR = 0.48, 95%CI: 0.27–0.87) or falls due to a slip or trip (aOR = 0.67, 95%CI: 0.47–0.95) in the subsequent month. Conclusions Given the exploratory nature of the study, these findings should be interpreted with caution. Future studies may investigate whether better pain management and tailored fall prevention in older people with chronic pain could lead to fewer falls.

中文翻译：

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社区老年人的慢性疼痛和跌倒情况：一项探索性研究

背景 慢性疼痛是导致老年人行动不便和跌倒的危险因素。对患有慢性疼痛的老年人跌倒情况的模式知之甚少。目的 研究慢性疼痛与跌倒环境（包括跌倒地点、跌倒时的活动以及老年人自我报告的跌倒原因）之间的关系。设计前瞻性队列研究。在马萨诸塞州波士顿市内/附近设置社区。受试者 MOBILIZE 波士顿研究招募了 765 名年龄≥70 岁的成年人。方法 在 4 年的随访期间，使用每月日历明信片和跌倒随访访谈记录疼痛严重程度、跌倒发生率和跌倒情况。执行广义估计方程模型来检查每月疼痛等级与随后一个月第一次跌倒的情况之间的关系。结果 与没有慢性疼痛的跌倒者相比，有中度至重度疼痛的跌倒者报告室内跌倒 (aOR = 1.93, 95%CI: 1.32–2.83)、在起居室或餐厅跌倒 (aOR = 2.06, 95%CI：1.27–3.36），以及因健康问题跌倒（aOR = 2.08，95%CI：1.16–3.74）或感到头晕或昏厥（aOR = 2.10，95%CI：1.08–4.11），但他们不太可能报告下楼梯时跌倒 (aOR = 0.48, 95%CI: 0.27–0.87) 或由于滑倒或绊倒而跌倒 (aOR = 0.67, 95%CI: 0.47–0.95)。结论 鉴于研究的探索性，应谨慎解释这些发现。