Is Pain Catastrophizing Associated with Poor Physical Performance and Falls in Older Adults with Chronic Pain? The Mobilize Boston Study II

Catastrophizing may play an important role in the exacerbation and perpetuation of pain and may predict poor mobility and increased fall risk in individuals with chronic pain. The objective of this study was to determine the association between pain catastrophizing and pain characteristics, between pain catastrophizing and physical performance, and between pain catastrophizing and rates of falls. Participants were 354 adults from the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly of Boston (MBS II), aged ≥ 70 years (mean=84.5y), and enrolled in the study between 2011 and 2015. Pain severity and pain interference were assessed by subscales of the Brief Pain Inventory. Pain distribution was classified as none, single site, and multisite. The Pain Catastrophizing Scale (PCS) was a 13-item scale (scored 13 to 65, with a score of \u3e 30 indicating high levels of pain catastrophizing). Mobility performance was assessed using the Short Physical Performance Battery (SPPB), and a usual-paced gait speed test. Falls were recorded on monthly calendar postcards. Linear regression models were performed to examine the association between pain catastrophizing and pain severity or pain interference, and between pain catastrophizing and SPPB or gait speed. Multinomial logistic regression models were conducted to determine the association between pain catastrophizing and pain distribution. Negative binomial regression models were conducted to explain the association between pain catastrophizing and fall rates. One-fourth of all participants (24%) had high levels of pain catastrophizing. Pain catastrophizing was higher in participants aged ≤ 80 years compared to those aged 91-101 years (mean=25.5 and 7.3, respectively) and in those with osteoarthritis, depression, or anxiety (p-valu