title: A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women.
abstract: Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established.
  
  
  
  We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale.
  
  
  
  Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls.
  
  
  
  Older community-dwelling women with a recent history of back pain are at increased risk for falls.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland. marshaly@ohsu.edu.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Marshall
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Litwack-Harrison
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.affiliation: Department of Family and Preventive Medicine and Department of Internal Medicine, University of California, San Diego.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Kado
authors.affiliation: Department of Family Medicine, Oregon Health and Science University, Portland.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Deyo
authors.affiliation: Department of Internal Medicine and Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas.
authors.forename: Una E
authors.initials: UE
authors.lastname: Makris
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland.
authors.forename: Hans L
authors.initials: HL
authors.lastname: Carlson
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000375:Aging; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Falls; Pain