Pain Is Associated with Recurrent Falls in Community-Dwelling Older Adults: Evidence from a Systematic Review and Meta-Analysis

Background: Pain and recurrent falls are highly problematic in community-dwelling older adults, yet the association remains elusive. Objective: The objective of this study was to investigate the association between pain and recurrent falls in community-dwelling older adults. Design: Two independent reviewers conducted searches of major electronic databases, completed methodological assessment, and extracted the data of all included articles. Articles that were included are those that 1) involved community-dwelling older adults; 2) recorded recurrent falls; and 3) assessed pain. Articles that were excluded are those that included participants with dementia, any neurological conditions, or those with orthopedic trauma/surgery in the past 6 months. Results: Out of a potential of 71 articles, 11 met the inclusion criteria and 7 (N=9,581) were eligible for the meta-analysis. The annual prevalence of recurrent falls in those reporting pain (12.9%) was higher than the pain-free control group (7.2%, P<0.001). A global meta-analysis established that pain was associated with recurrent falls (odds ratio [OR]: 2.04, confidence interval [CI]: 1.75-2.39; N=3,950 with pain and N=5,631 controls), and this was decreased in a subgroup meta-analysis utilizing prospective studies only (OR: 1.79, CI: 1.44-2.21, P<0.001, I