Multisite Pain Is Longitudinally Associated with an Increased Risk of Fall among Older Adults with or at Risk of Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Objective The aim of the study is to examine the association between baseline multisite pain (two and three or more sites) and longitudinal risk of fall and recurrent falls among older adults with or at risk of knee osteoarthritis. Design This prospective longitudinal cohort study included older adults with or at risk of knee osteoarthritis. Fall, including the history of falls, number of falls, and recurrent falls, were assessed at baseline and during six follow-up visits at 12, 24, 36, 48, 72, and 96 mos. Multisite pain was categorized into the following four categories: no pain, one site, two sites, ≥three sites. Results This study included 2585 older adults. Baseline two sites (odds ratio = 1.50, P = 0.018) and ≥three sites (odds ratio = 1.89, P < 0.001) were significantly associated with increased risk of fall over time compared to no pain sites. Baseline two sites (incidence rate ratio = 1.44, P = 0.024) and ≥three sites (incidence rate ratio = 1.73, P < 0.001) were significantly associated with an increased number of falls over time. Only ≥three sites were associated with the recurrent falls (odds ratio = 2.16, P = 0.003). Conclusions Baseline multisite pain (≥3 sites) was longitudinally associated with increased fall incidence, number of falls, and recurrent falls over 7 yrs of follow-up.