Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, New South Wales, Australia.
School of Health, University of New South Wales, Sydney, New South Wales, Australia.
Eur J Pain. 2022 Oct;26(9):1923-1937. doi: 10.1002/ejp.2013. Epub 2022 Sep 1.
Few studies have explored the impact of low back or lower limb pain severity on recurrent (≥2) falls in older adults.
Investigate the association between the severity of low back or lower limb pain, and ≥2 falls or falls-related injuries.
Community-dwelling Australian males and females in the ASPREE Longitudinal Study of Older Persons (ALSOP), aged ≥70 years. Self-reported, cross-sectional questionnaire data regarding number of falls and falls-related injuries in the last 12 months; and sites and severity of pain experienced on most days. Adjusted relative risks (RR) were estimated from multivariable Poisson regression models, for males and females separately.
Of 14,892 ALSOP participants, 13% (n = 1983) reported ≥2 falls ('recurrent fallers') in the last 12 months. Males and females who reported severe low back, or severe lower limb pain on most days were more likely to report ≥2 falls in the last 12 months compared to those with mild pain (lower back: males RR = 1.70 and females RR = 1.5, p = 0.001; lower limb: males RR = 2.0, p < 0.001 and females RR = 1.4, p = 0.003). Female recurrent fallers who reported severe low back (RR = 1.3, p = 0.029) or lower limb (RR = 1.2, p = 0.024) pain on most days were more likely to report a falls-related injury in the last 12 months compared to females with mild pain.
Severe low back or lower limb pain was associated with an increased likelihood of recurrent falls (males/females) or falls-related injuries (females only). Assessment of severe low back and lower limb pain should be considered as a priority when undertaking falls-risk evaluation.
Severe low back pain, or severe lower limb pain is associated with an increased likelihood of recurrent falls in older males and females, and an increased likelihood of falls-related injuries in older female recurrent fallers. Assessment and management of severe low back and lower limb pain should be prioritized when undertaking falls-risk assessment. Future longitudinal research is required to further interrogate this relationship and its underlying mechanisms.
很少有研究探讨下腰痛或下肢疼痛严重程度对老年人复发性（≥2 次）跌倒的影响。
调查下腰痛或下肢疼痛严重程度与≥2 次跌倒或跌倒相关损伤之间的关系。
在 ASPREE 老年人纵向研究（ALSOP）中，年龄≥70 岁的澳大利亚社区居住的男性和女性。在过去 12 个月中，使用自我报告的、横断面问卷调查数据报告跌倒次数和跌倒相关伤害；以及大多数日子经历的疼痛部位和严重程度。使用多变量泊松回归模型，分别对男性和女性进行调整后的相对风险（RR）估计。
在 14892 名 ALSOP 参与者中，13%（n=1983）报告在过去 12 个月中发生≥2 次跌倒（“复发性跌倒者”）。与轻度疼痛相比，报告大多数日子有严重下腰痛或严重下肢痛的男性和女性更有可能在过去 12 个月内报告≥2 次跌倒（下腰痛：男性 RR=1.70 和女性 RR=1.5，p=0.001；下肢痛：男性 RR=2.0，p<0.001 和女性 RR=1.4，p=0.003）。报告大多数日子有严重下腰痛（RR=1.3，p=0.029）或严重下肢痛（RR=1.2，p=0.024）的女性复发性跌倒者，在过去 12 个月内报告跌倒相关伤害的可能性高于报告轻度疼痛的女性。
严重下腰痛或下肢痛与复发性跌倒（男性/女性）或跌倒相关伤害（仅女性）的可能性增加有关。在进行跌倒风险评估时，应优先评估严重下腰痛和下肢痛。
严重下腰痛或严重下肢痛与老年男性和女性复发性跌倒的可能性增加有关，与老年女性复发性跌倒者跌倒相关伤害的可能性增加有关。在进行跌倒风险评估时，应优先评估严重下腰痛和下肢痛。需要进一步的纵向研究来进一步探讨这种关系及其潜在机制。
