» Articles » PMID: 36428490

Association of Pain Phenotypes with Risk of Falls and Incident Fractures

Overview
Journal Biomedicines
Date 2022 Nov 26
PMID 36428490
Authors
Affiliations
Soon will be listed here.
Abstract

To compare whether falls risk score and incident fracture over 10.7 years were different among three previously identified pain phenotypes. Data on 915 participants (mean age 63 years) from a population-based cohort study were studied at baseline and follow-ups at 2.6, 5.1 and 10.7 years. Three pain phenotypes were previously identified using the latent class analysis: Class 1: high prevalence of emotional problems and low prevalence of structural damage; Class 2: high prevalence of structural damage and low prevalence of emotional problems; Class 3: low prevalence of emotional problems and low prevalence of structural damage. Fractures were self-reported and falls risk score was measured using the Physiological Profile Assessment. Generalized estimating equations model and linear mixed-effects model were used to compare differences in incident fractures and falls risk score over 10.7 years between pain phenotypes, respectively. There were 3 new hip, 19 vertebral, and 121 non-vertebral fractures, and 138 any site fractures during 10.7-year follow-up. Compared with Class 3, Class 1 had a higher risk of vertebral (relative risk (RR) = 2.44, 95% CI: 1.22-4.91), non-vertebral fractures (RR = 1.20, 95% CI: 1.01-1.42), and any site fractures (RR = 1.24, 95% CI: 1.04-1.46) after controlling for covariates, bone mineral density and falls risk score. Class 2 had a higher risk of non-vertebral and any site fracture relative to those in Class 3 (non-vertebral: RR = 1.41, 95% CI: 1.17-1.71; any site: RR = 1.44, 95% CI: 1.20-1.73), but not vertebral fracture. Compared with Class 3, Class 1 had a higher falls risk score at baseline (β = 0.16, 95% CI: 0.09-0.23) and over 10.7-year (β = 0.03, 95% CI: 0.01-0.04). Class 1 and/or Class 2 had a higher risk of incident fractures and falls risk score than Class 3, highlighting that targeted preventive strategies for fractures and falls are needed in pain population.

References
1.
Stubbs B, Schofield P, Binnekade T, Patchay S, Sepehry A, Eggermont L . Pain is associated with recurrent falls in community-dwelling older adults: evidence from a systematic review and meta-analysis. Pain Med. 2014; 15(7):1115-28. DOI: 10.1111/pme.12462. View

2.
Lord S, Menz H, Tiedemann A . A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003; 83(3):237-52. View

3.
. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100):1211-1259. PMC: 5605509. DOI: 10.1016/S0140-6736(17)32154-2. View

4.
Smith D, Wilkie R, Croft P, McBeth J . Pain and Mortality in Older Adults: The Influence of Pain Phenotype. Arthritis Care Res (Hoboken). 2017; 70(2):236-243. DOI: 10.1002/acr.23268. View

5.
Cai Y, Leveille S, Shi L, Chen P, You T . Chronic pain and circumstances of falls in community-living older adults: an exploratory study. Age Ageing. 2022; 51(1). PMC: 8782600. DOI: 10.1093/ageing/afab261. View