Article

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;
I(2)=53%). A subgroup meta-analysis incorporating studies that monitored falls
prospectively established that the odds of falling were significantly higher in
those with pain (n=4674; OR=1.71; 95% CI, 1.48-1.98; I(2)=0%). Foot pain was
strongly associated with falls (n=691; OR=2.38; 95% CI, 1.62-3.48; I(2)=8%) as
was chronic pain (n= 5367; OR=1.80; 95% CI, 1.56-2.09; I(2)=0%). CONCLUSIONS:
Community-dwelling older adults with pain were more likely to have fallen in the
past 12 months and to fall again in the future. Foot and chronic pain were
particularly strong risk factors for falls, and clinicians should routinely
inquire about these when completing falls risk assessments.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS