title: Pain interference is associated with psychological concerns related to falls in community-dwelling older adults: multisite observational study.
abstract: BACKGROUND
  Pain interference and psychological concerns related to falls (PCRF) are pervasive phenomena among community-dwelling older adults, yet their association remains elusive.
  
  
  OBJECTIVE
  The purpose of this study was to establish whether pain interference is associated with PCRF in community-dwelling older adults.
  
  
  METHODS
  This was a multisite cross-sectional study.
  
  
  METHODS
  Two hundred ninety-five community-dwelling older adults (mean age=77.5 years, SD=8.1; 66.4% female) participated in the study. All participants completed the Brief Pain Inventory (BPI) interference subscale, Short Falls Efficacy Scale-International (FES-I), Activities-specific Balance Confidence Scale (ABC), modified version of the Survey of Activities and Fear of Falling in Elderly Scale (mSAFFE), and Consequences of Falling Scale (CoF). Hierarchical multiple regression analysis were conducted. In the first step of the study, sociodemographic and known risk factors for psychological concerns related to falls were inserted into the model, followed by the BPI interference subscale score in the second step.
  
  
  RESULTS
  One hundred sixty-nine participants (57.3%) reported some pain interference. The BPI interference subscale was highly correlated with all PCRF (r>.5, P<.0001). After the adjustment for established risk factors, the BPI interference subscale significantly increased the variance in the Short FES-I (R2 change=13.2%), ABC (R2 change=4.7%), mSAFFE (R2 change=5.0%), and CoF (R2 change=10.0%). Pain interference was a significant and independent predictor in the final model for the Short FES-1 (β=0.455, P<.001), ABC (β=-0.265, P<.001), mSAFFE (β=0.276, P<.001), and CoF (β=0.390, P<.001).
  
  
  CONCLUSIONS
  The study was cross-sectional.
  
  
  CONCLUSIONS
  Pain interference is an important contributing factor in each of the psychological concerns related to falls. Pain interference had the strongest impact on reducing falls efficacy and increasing older adults' concerns about the consequences of falling.
authors.affiliation: B. Stubbs, PT, MSc, MCSP, Health and Social Care, University of Greenwich, Avery Hill Road, New Eltham, London, SE9 2UG, United Kingdom. b.stubbs@greenwich.ac.uk brendonstubbs@hotmail.com.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: L.H.P. Eggermont, PhD, Neuropsychology, VU University, Amsterdam, the Netherlands.
authors.forename: Laura H P
authors.initials: LH
authors.lastname: Eggermont
authors.affiliation: S. Patchay, PhD, Faculty of Education and Health, University of Greenwich.
authors.forename: Sandhi
authors.initials: S
authors.lastname: Patchay
authors.affiliation: P.A. Schofield, PhD, Faculty of Education and Health, University of Greenwich.
authors.forename: Pat A
authors.initials: PA
authors.lastname: Schofield
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D010146:Pain / Q000517:prevention & control* / Q000523:psychology*; D010147:Pain Measurement; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D020377:Self Efficacy