Investigating multisite pain as a predictor of self-reported falls and falls requiring health care use in an older population: a prospective cohort study
Investigating multisite pain as a predictor of self-reported falls and falls requiring health care use in an older population: a prospective cohort study
Older people are continuing to fall despite fall prevention guidelines targeting known falls’ risk factors. Multisite pain is a potential novel falls’ risk factor requiring further exploration. This study hypothesises that: (1) an increasing number of pain sites and widespread pain predicts self-reported falls and falls recorded in primary and secondary healthcare records; (2) those relationships are independent of known falls’ risk factors and putative confounders. This prospective cohort study linked data from self-completed questionnaires, primary care electronic health records, secondary care admission statistics and national mortality data. Between 2002–2005, self-completion questionnaires were mailed to community-dwelling individuals aged 50 years and older registered with one of eight general practices in North Staffordshire, UK(n = 26,129) yielding 18,497 respondents. 11,375 respondents entered the study; 4386 completed six year follow-up. Self-reported falls were extracted from three and six year follow-up questionnaires. Falls requiring healthcare were extracted from routinely collected primary and secondary healthcare data. Increasing number of pain sites increased odds of future 3 year (odds ratio 1.12 (95% confidence interval: 1.01–1.24)) and 6 year self-reported fall (odds ratio 1.02 (1.00–1.03)) and increased hazard of future fall requiring primary healthcare (hazard ratio 1.01 (1.00–1.03)). The presence of widespread pain increased odds of future 3 year (odds ratio 1.27 (0.92–1.75)) and 6 year fall (odds ratio 1.43(1.06–1.95)) and increased hazard of future fall requiring primary healthcare (hazard ratio 1.27(0.98–1.65)). Multisite pain was not associated with future fall requiring secondary care admission. Multisite pain must be included as a falls’ risk factor in guidelines to ensure clinicians identify their older patients at risk of falls and employ timely implementation of current falls prevention strategies.
McBeth, John
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Welsh, Victoria K.
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Mallen, Christian D.
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Ogollah, Reuben
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Wilkie, Ross
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McBeth, John
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11 December 2019
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61
Welsh, Victoria K.
bc0b338a-12b7-4bfb-ae27-717e78d12ab4
Mallen, Christian D.
b6745975-69e1-42b6-b617-37f393237024
Ogollah, Reuben
c657dc51-c77d-4638-97d1-a213a3fd4c06
Wilkie, Ross
1181d3c6-b503-442b-a877-f967c3f4f9e3
McBeth, John
e734c391-6857-444a-88a9-f6d6fdad6323
McBeth, John, Welsh, Victoria K., Mallen, Christian D., Ogollah, Reuben, Wilkie, Ross and McBeth, John
(2019)
Investigating multisite pain as a predictor of self-reported falls and falls requiring health care use in an older population: a prospective cohort study.
PLoS ONE, 14 (12), [e0226268].
(doi:10.1371/journal.pone.0226268).
Abstract
Older people are continuing to fall despite fall prevention guidelines targeting known falls’ risk factors. Multisite pain is a potential novel falls’ risk factor requiring further exploration. This study hypothesises that: (1) an increasing number of pain sites and widespread pain predicts self-reported falls and falls recorded in primary and secondary healthcare records; (2) those relationships are independent of known falls’ risk factors and putative confounders. This prospective cohort study linked data from self-completed questionnaires, primary care electronic health records, secondary care admission statistics and national mortality data. Between 2002–2005, self-completion questionnaires were mailed to community-dwelling individuals aged 50 years and older registered with one of eight general practices in North Staffordshire, UK(n = 26,129) yielding 18,497 respondents. 11,375 respondents entered the study; 4386 completed six year follow-up. Self-reported falls were extracted from three and six year follow-up questionnaires. Falls requiring healthcare were extracted from routinely collected primary and secondary healthcare data. Increasing number of pain sites increased odds of future 3 year (odds ratio 1.12 (95% confidence interval: 1.01–1.24)) and 6 year self-reported fall (odds ratio 1.02 (1.00–1.03)) and increased hazard of future fall requiring primary healthcare (hazard ratio 1.01 (1.00–1.03)). The presence of widespread pain increased odds of future 3 year (odds ratio 1.27 (0.92–1.75)) and 6 year fall (odds ratio 1.43(1.06–1.95)) and increased hazard of future fall requiring primary healthcare (hazard ratio 1.27(0.98–1.65)). Multisite pain was not associated with future fall requiring secondary care admission. Multisite pain must be included as a falls’ risk factor in guidelines to ensure clinicians identify their older patients at risk of falls and employ timely implementation of current falls prevention strategies.
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Accepted/In Press date: 24 November 2019
Published date: 11 December 2019
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Local EPrints ID: 491481
URI: http://eprints.soton.ac.uk/id/eprint/491481
ISSN: 1932-6203
PURE UUID: 0d3c879a-bf12-426f-b53e-5f4ed8ae9f12
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Date deposited: 25 Jun 2024 16:31
Last modified: 26 Jun 2024 02:11
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Author:
John McBeth
Author:
Victoria K. Welsh
Author:
Christian D. Mallen
Author:
Reuben Ogollah
Author:
Ross Wilkie
Author:
John McBeth
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