Association of pain with falls and fractures among middle-aged Korean community-dwelling adults

Abstract

The relationship between pain and falls remains controversial. Therefore, this study explored the associations between pain and fall-related outcomes in 5,340 middle-aged (45-65 years) adults residing in the communities in Korea. Pain was defined as pain at any location, pain-related activity restriction (PAR), and persistent pain. The outcome measures included fall injuries, recurrent falls, injurious falls, and fall-related hip fractures. A multivariate logistic regression model was used to examine the relationship between pain and fall outcome. Among the study participants, 54.0% reported having experienced pain. During a follow-up period of up to 14 years, those who reported pain and PAR at baseline exhibited a positive association with the occurrence of fall injury (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.27-2.53) and injurious falls (OR 1.72, 95% CI 1.20-2.48) but not with recurrent falls (OR 1.90, 95% CI 0.80-4.54). We also observed a positive association between persistent pain and the risk of fall injury (OR 1.41, 95% CI 1.13-1.91), whereas no consistent conclusions were drawn regarding the risk of recurrent falls and injurious falls. We also did not identify any correlation between pain and hip fractures resulting from falls. In conclusion, our findings of the positive correlations of pain and PAR at baseline with fall injuries and injurious falls but not recurrent falls during follow-up suggest that public health initiatives should prioritize pain screening, especially for participants reporting ankle and toe pain, and implement suitable interventions to mitigate the risk of falls and the associated adverse outcomes among middle-aged adults.

Keywords: Fall-related outcomes; Hip fractures; Middle-aged adults; Pain.