Welsh, Victoria Kay (2018) Multisite pain and falls in older people. Doctoral thesis, Keele University.

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Abstract

Falls are a common occurrence in older people and multisite pain has been identified as a potential falls risk factor in this age group. This thesis aims to describe the relationship between multisite pain and falls in community-dwelling older people.

A systematic review identified 20 studies investigating multisite pain and falls. Meta-analysis showed multisite pain increased the odds of falling.

Data from the North Staffordshire Osteoarthritis Project, a prospective cohort study of community-dwelling adults aged ≥50 years with follow ups at three and six years, was used. Survey data was linked with general practice (GP) records, Hospital Episode Statistics (HES) and Office for National Statistics mortality data. Logistic regression tested the relationship between multisite pain and risk of self-reported falls in 4386 participants with complete data. Survival analysis tested the relationship between multisite pain and risk of GP or HES recorded falls in 11,375 participants. Analyses were adjusted for confounders and putative influencers of the pain-falls relationship.

Multisite pain most strongly predicted future self-reported falls, followed by GP recorded falls. Multisite pain was not associated with HES recorded falls. Increasing age, being female, increasing number of medications used and strong analgesic use predicted all future falls; increasing cognitive complaint and previous self-reported fall additionally predicted GP recorded falls and all confounders and putative influencers predicted self-reported falls and had a significant association with multisite pain.

These data suggest that multisite pain is an independent risk factor for self-reported falls. In addition, multisite pain is a likely influencer of the relationship between other risk factors and future falls.

Primary care should proactively identify older adults with multisite pain due to their increased risk of falling and instigate falls prevention management according to current guidelines. Future research will establish the impact of pain management interventions on future risk of falls.

Item Type: Thesis (Doctoral)
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Lisa Bailey
Date Deposited: 16 Mar 2018 12:07
Last Modified: 16 Mar 2018 12:07
URI: http://eprints.keele.ac.uk/id/eprint/4580

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