title: A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Men.
abstract: BACKGROUND
  Musculoskeletal pain is associated with increased fall risk among older men. However, the association of back pain, the most prevalent type of pain in this population, and fall risk is unknown.
  
  
  METHODS
  We conducted a prospective investigation among 5,568 community-dwelling U.S. men at least 65 years of age from the Osteoporotic Fractures in Men Study (MrOS). Baseline questionnaires inquired about back pain and its location (such as low back), severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Outcomes were recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and fall risk were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression models adjusted for age, dizziness, arthritis, knee pain, urinary symptoms, self-rated health, central nervous system medication use, and instrumental activities of daily living.
  
  
  RESULTS
  Most (67%) reported any back pain in the past year. During follow-up, 11% had recurrent falls and 25% fell at least once. Compared with no back pain, any back pain was associated with elevated recurrent fall risk (multivariable RR = 1.3, 95% CI: 1.1, 1.5). Multivariable RRs for 1, 2, and 3+ back pain locations were, respectively, 1.2 (95% CI: 1.0, 1.5), 1.4 (1.1, 1.8), and 1.7 (95% CI: 1.3, 2.2). RRs were also elevated for back pain severity and frequency. Back pain was also associated with risk of any fall.
  
  
  CONCLUSIONS
  Among older men, back pain is independently associated with increased fall risk.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland.
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: Department of Internal Medicine, VA North Texas Health Care System.|Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
authors.forename: Una E
authors.initials: UE
authors.lastname: Makris
authors.affiliation: Department of Family Medicine and Public Health.|Department of Internal Medicine, University of California, San Diego.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Kado
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 Medicine, Oregon Health and Science University, Portland.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Deyo
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland.
authors.forename: Nels L
authors.initials: NL
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; D001416:Back Pain / Q000453:epidemiology*; D006801:Humans; D057187:Independent Living; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Cohort studies; Epidemiology; Public health; Risk factors