title: Pain and falls and fractures in community-dwelling older men.
abstract: BACKGROUND
  Pain may reduce stability and increase falls and subsequent fractures in older men.
  
  
  OBJECTIVE
  To examine the association between joint pain and any pain with falls, hip and non-spine fractures in older community-dwelling men.
  
  
  METHODS
  A cohort study.
  
  
  METHODS
  Analyses included 5,993 community-dwelling men aged ≥65 years from the MrOS cohort.
  
  
  METHODS
  Pain at hip, knee and elsewhere (any) was assessed by self-report. Men reported falls via questionnaires mailed 3× per year during the year following the baseline visit. Fractures were verified centrally. Mean follow-up time for fractures was 9.7 (SD 3.1) years. Logistic regression models estimated likelihood of falls and proportional hazards models estimated risk of fractures. Models were adjusted for age, BMI, race, smoking, alcohol use, medications use, co-morbidities and arthritis; fracture models additionally adjusted for bone mineral density.
  
  
  RESULTS
  One quarter (25%, n = 1,519) reported ≥1 fall; 710 reported ≥2 falls in the year after baseline. In multivariate models, baseline pain at hip, knee or any pain increased likelihood of ≥1 fall and ≥2 falls over the following year. For example, knee pain increased likelihood of ≥1 fall (odds ratio, OR 1.44; 95% confidence interval, CI 1.25-1.65) and ≥2 falls (OR 1.75; 95% CI 1.46-2.10). During follow-up, 936 (15.6%) men suffered a non-spine fracture (n = 217, 3.6% hip). In multivariate models, baseline pain was not associated with incident hip or non-spine fractures.
  
  
  CONCLUSIONS
  Any pain, knee pain and hip pain were each strong independent risk factors for falls in older men. Increased risk of falls did not translate into an increased risk of fractures.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus 8200, Denmark California Pacific Medical Center Research Institute, San Francisco, CA, USA.
authors.forename: Troels
authors.initials: T
authors.lastname: Munch
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Harrison
authors.affiliation: University of California, San Diego, CA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Internal Medicine, University of California, Davis, Davis, CA, USA.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.affiliation: Park Nicollet Institute for Research and Education, St Louis Park, MN, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Schousboe
authors.affiliation: Department of Medicine, Stanford University, Stanford Prevention Research Center, Palo Alto, CA, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Stefanick
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, USA.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D018771:Arthralgia / Q000150:complications* / Q000453:epidemiology; D015519:Bone Density; D015331:Cohort Studies; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: MrOS; cohort; fall; fracture; older people; pain