ORs were generally higher for recurrent fallers than for all fallers .
This meta- analysis provides comprehensive evidence -based assessment of risk factors for falls in older people , confirming their multifactorial etiology .
Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling
BACKGROUND Falls are the main cause of accidental death in persons aged 65 years or older .
Musculoskeletal pain and risk for falls in older disabled women living in the community.
OBJECTIVES To determine whether musculoskeletal pain increased risk for falls in older women with disabilities . DESIGN Prospect i ve population -based cohort study . SETTING The city and county of the eastern area of Baltimore . PARTICIPANTS One thous and two women aged 65 and older , participants in the Women 's Health and Aging Study , representing the one-third of older women who were living at home with disabilities , followed semiannually for 3 years beginning in 1991 . MEASUREMENTS Pain was categorized into four groups according to severity and location . Widespread pain was defined as pain in the upper and lower extremities and in the axial skeletal region , with moderate to severe pain in at least one region ( > or = 4 on a 10-point numeric rating scale , 10 = excruciating pain ) . Moderate to severe lower extremity pain that did not meet criteria for widespread pain was the next category . The reference category was no pain or mild pain in one site . The additional category of " other pain " was pain that did not fit into the other three groups . The occurrence of falls and fall-related injuries were assessed at each interview . RESULTS Of the 940 women who participated in at least one follow-up examination , 39 % fell in first year ; of the survivors , 36 % fell in Year 2 , and 39 % in Year 3 . After adjusting for several major risk factors for falls , women with widespread pain had an increased likelihood of falling during follow-up ( adjusted odds ratio ( AOR ) = 1.66 , 95 % confidence interval ( CI ) = 1.25 - 2.21 ) compared with those with no or mild pain in only one musculoskeletal site . Women who had other musculoskeletal pain but not widespread pain or lower extremity pain also had an increased risk of falls ( AOR = 1.36 , 95 % CI = 1.02 - 1.82 ) . Among women with musculoskeletal pain , risk for falls was lower in those who used daily analgesic medication . Risk for recurrent falls and self-reported fractures due to falls was also elevated in women with musculoskeletal pain , most consistently in women with widespread pain . CONCLUSIONS Musculoskeletal pain , particularly widespread pain , is a substantial risk factor for falls in older women with disabilities . These findings add an important dimension to our underst and ing of the multifactorial processes leading to falls in older persons
ORs were generally higher for recurrent fallers than for all fallers .
This meta- analysis provides comprehensive evidence -based assessment of risk factors for falls in older people , confirming their multifactorial etiology .
Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling
BACKGROUND Falls are the main cause of accidental death in persons aged 65 years or older .