title: Older adults with chronic musculoskeletal pain are at increased risk of recurrent falls and the brief pain inventory could help identify those most at risk.
abstract: OBJECTIVE
  Chronic musculoskeletal pain (CMP) and falls are common among community-dwelling older adults. The study aims were: (i) to investigate the relationship between CMP and any falls (≥1), single falls and recurrent falls (≥2) in community-dwelling older adults; and (ii) to determine the discriminative validity of the Brief Pain Inventory (BPI) to differentiate between non-fallers and (a) any and (b) recurrent fallers.
  
  
  METHODS
  A cross-sectional study involving 295 community-dwelling participants (mean age 77.5 ± 8.1 years, 66.4% female) was carried out. CMP was assessed and classified as none (comparison group), single and multisite (≥2). The BPI severity and interference subscales were used, and falls were recorded over 12 months. Data were analyzed with logistic regression and receiver operating characteristic curves (ROC).
  
  
  RESULTS
  Over half of the participants (154/295, 52.2%) had CMP (41.6% single and 58.4% multisite pain). Participants with CMP were at increased risk of recurrent falls (OR 2.25, 95% CI 1.03-4.88), and this risk was highest in those with multisite CMP (OR 3.43, CI 1.34-8.65). The BPI severity subscale showed good discriminative ability to differentiate between recurrent and non-fallers with an area under the curve (AUC) of 0.731 (95% CI 0.635-0.826); a mean score of 5.1 had a sensitivity of 93.3% and specificity of 56.7%. The AUC for the BPI interference subscale was 0.724 (95% CI 0.630-0.818), and a cut-off score of 4.6 had a sensitivity of 84.4% and specificity of 57.8%
  
  
  CONCLUSIONS
  Older adults with multisite CMP are at greatest risk of recurrent falls. In clinical settings, the BPI could prove useful to discriminate between recurrent and non-fallers.
authors.affiliation: School of Health and Social Care, University of Greenwich, London, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, the Netherlands.
authors.forename: Laura
authors.initials: L
authors.lastname: Eggermont
authors.affiliation: School of Psychology and Counselling, University of Greenwich, London, UK.
authors.forename: Sandhi
authors.initials: S
authors.lastname: Patchay
authors.affiliation: School of Health and Social Care, University of Greenwich, London, UK.
authors.forename: Pat
authors.initials: P
authors.lastname: Schofield
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D010147:Pain Measurement / Q000379:methods*; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: community-dwelling older adults; falls; falls screening tool; musculoskeletal pain; recurrent falls