The association between musculoskeletal pain and physical activity, falls and psychological concerns related to falls in community dwelling older adults

Background Chronic musculoskeletal pain (CMP) is a common pervasive issue among older adults and may affect mobility and falls risk. Aims Investigate the relationship between CMP and physical activity/ sedentary behaviour, psychological concerns related to falls and falls in community dwelling older adults. Method A mixed method sequential explanatory approach was adopted, informed by three systematic reviews. Five quantitative studies were devised and community dwelling older adults were recruited across 10 sites in London. CMP was assessed and standardised information regarding falls, psychological concerns related to falls, sedentary behaviour and confounding factors collected. A convenience sample of 20 participants with CMP were recruited exploring the three phenomenon using semi structured interviews. Results Overall, 295 participants participated in the quantitative studies (77.5±8.1 years, 66.4% female) and 52% had CMP (154/295). The first results paper demonstrated that older adults with CMP were more sedentary than those without CMP (11.5 hours vs 7.9, p<.001). The second results study elucidated that older adults with multisite CMP are at greatest risk of recurrent falls (odds ratio 2.25, 95% confidence interval: 1.03-4.88) and that the brief pain inventory (BPI) demonstrates promising discriminative ability. The third and fourth results studies demonstrated that high pain interference, pain severity and multisite pain were associated with increased concerns regarding falling (particularly lower balance confidence). The final quantitative results chapter demonstrated that collectively these mobility limitations and falls risk factors are significantly associated with lower health related quality of life in those with CMP. The qualitative study suggests that these relationships may not be that straight forward with few participants directly attributing pain as a cause of falls or increased concerns about falling. Conclusion Older adults with CMP are significantly more likely to experience falls, be more sedentary and have heightened psychological concerns related to falls compared to those without CMP.