Pain and the Risk for Falls in Community-Dwelling Older Adults: Systematic Review and Meta-Analysis

Objective: To conduct a systematic review and meta-analysis to establish the association between pain and falls in community-dwelling older adults. Data Sources: Electronic databases from inception until March 1, 2013, including Cochrane Library, CINAHL, EBSCO, EMBASE, PubMed, and PsycINFO. Study Selection: Two reviewers independently conducted the searches and completed methodological assessment of all included studies. Studies were included that (1) focused on adults older than 60 years; (2) recorded falls over 6 or more months; and (3) identified a group with and without pain. Studies were excluded that included (1) participants with dementia or a neurologic condition (eg, stroke); (2) participants whose pain was caused by a previous fall; or (3) individuals with surgery/fractures in the past 6 months. Data Extraction: One author extracted all data, and this was independently validated by another author. Data Synthesis: A total of 1334 articles were screened, and 21 studies met the eligibility criteria. Over 12 months, 50.5% of older adults with pain reported 1 or more falls compared with 25.7% of controls (P<.001). A global meta-analysis with 14 studies (n=17,926) demonstrated that pain was associated with an increased odds of falling (odds ratio [OR]=1.56; 95% confidence interval [CI], 1.36-1.79;