Beth Israel Deaconess Medical Center We had reported in our previous article that mood-altering drugs could lead to falls among elderly. Now pertaining to the topic, a study claims that older adults, who apparently accounted for chronic musculoskeletal pain in two or more places, go through elevated levels of severe pain, or pain that supposedly intervened with their every day activities were said to have more chances to experience a fall. This was compared to adults who did not account for these kinds of pain.

The authors mentioned that falls rank among the 10 leading causes of death in older adults in the United States, leading to more than $19 billion in health care costs yearly. In spite of a growing body of scientific evidence supporting associations between a number of risk factors and falls, efforts to translate these findings into effective fall prevention strategies have been limited. Apparently, some reports have analyzed chronic pain as a threat for falls in older adults.

The authors commented, “Pain contributes to functional decline and muscle weakness and is associated with mobility limitations that could predispose to falls.”

A study was performed by Suzanne G. Leveille, Ph.D., R.N., of Beth Israel Deaconess Medical Center and the University of Massachusetts-Boston, and colleagues to find out whether chronic musculoskeletal pain is linked with an augmented incidence of falls in older adults. Around 749 adults who were 70 years or older participated in the study. They were believed to be enlisted in the study from September 2005 till January 2008. Pain was supposedly examined by means of questionnaires. Subjects apparently documented their falls on monthly calendar postcards mailed to the study center during an 18-month duration.

At the commencement of the study, around 40 percent of subjects supposedly accounted for chronic pain in more than one joint region and about 24 percent experienced chronic pain in only one joint area. A sum of around 1,029 falls was accounted by the 749 participants during and up to 18 months of follow-up. Around 405 participants apparently fell at least once during the follow-up.

Investigation apparently pointed out that as opposed to participants who reported no pain or those in the lowest groups of pain scores, participants who accounted for two or more locations of pain apparently experienced an augmented threat for falls. Also those who were accounting for the maximum levels of pain severity also appeared to have an increased rate of falls. Pain interference with activities also seemed to be linked to a larger incidence of falls. The experts apparently noted a powerful graded association in the short term between pain severity ratings every month with threat for falls in the following month.

The authors remarked, “For example, among persons who reported severe or very severe pain for any given month on their calendar postcard, there was a 77 percent increased likelihood for a fall in the subsequent month compared with those who reported no pain.”

It was seen that people accounting for even very slight pain also appeared to have higher chances of falling in any given month. The authors propose that there could be numerous probable mechanisms for the pain-falls association, counting neuromuscular effects of pain, which could result in leg muscle weakness or slow neuromuscular responses to an approaching fall.

The authors quoted, “Another factor may be gait alterations or adaptations to chronic pain that lead to instability and subsequent balance impairments. Chronic pain may serve as a distractor or, in some way, interfere with cognitive activity needed to prevent a fall. Successful avoidance or interruptions of a fall typically requires a cognitively mediated physical maneuver.”

The authors stated, “The findings provide evidence suggesting that the common complaint of the aches and pains of old age is related to a greater hazard than previously thought. Daily discomfort may accompany not only difficulties in performing daily activities but equally as important may be a risk for falls and possibly fall-related injuries in the older population. The significance of this work is in the identification of chronic pain as an overlooked and potentially important risk factor for falls in older adults.”

The experts concluded by mentioning that a randomized controlled trial is needed to determine whether improved pain control could reduce risk for falls among older patients with chronic pain.

The study was published in JAMA.