Neck pain,concerns of falling and physical performance in community-dwelling Danish citizens over 75 years of age: A cross-sectional study

Abstract

Aims: The aim of this study was to determine the associations between neck pain, concerns of falling and physical performance in older people. Methods: Cross-sectional study of 423 community-dwelling Danes aged 75 years and older. Measures consisted of self-reported neck pain, physical performance (Short Physical Performance Battery), self-reported psychological concerns related to falling (Falls Efficacy Scale International), depression (Major Depression Inventory), cognitive function (Mini Mental State Examination), self-reported low-back pain and self-reported history of falls. Associations between neck pain and fear of falling were determined using multivariable logistic regression modelling. Results: Bothersome neck pain that limits daily activities is significantly associated with concerns of falling (unadjusted odds ratio (OR) 3.29, 95% confidence interval (CI) 1.54–7.03) and impaired physical performance (unadjusted OR 2.26, 95% CI 1.09–4.69). However, these relationships became nonsignificant after adjusting for potential confounders. Bothersome neck pain and concerns of falling is attenuated by depression, and the relationship between bothersome neck pain and decreased physical performance is attenuated by concerns of falling, depression and previous history of falls. Conclusions: Bothersome neck pain in older people is associated with increased concerns of falling and decreased physical performance that are two known risk factors for falls in older people. However, these relationships are complicated by other variables, particularly depression.

Keywords

Aged pain fear of falling physical performance

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References

Shega

Weiner

Paice

. The association between noncancer pain, cognitive impairment, and functional disability: an analysis of the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 2010;65:880–6.

Hartvigsen

Frederiksen

Christensen

. Back and neck pain in seniors-prevalence and impact. Eur Spine J 2006;15:802–6.

Leveille

Bean

Bandeen-Roche

. Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc 2002;50:671–8.

Stubbs

West

Patchay

. Is there a relationship between pain and psychological concerns related to falling in community dwelling older adults? A systematic review. Disabil Rehabil 2014;36(23):1931–42.

Stubbs

Schofield

Patchay

. Musculoskeletal pain characteristics associated with lower balance confidence in community-dwelling older adults. Physiotherapy 2016;102(2):152–8.

Leveille

Jones

Kiely

. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA 2009;302:2214–21.

Blyth

Cumming

Mitchell

. Pain and falls in older people. Eur J Pain 2007;11:564–71.

Munch

Harrison

Barrett-Connor

. Pain and falls and fractures in community-dwelling older men. Age Ageing 2015;44:973–9.

Deandrea

Lucenteforte

Bravi

. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010;21:658–68.

10.

Tiedemann

Shimada

Sherrington

. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing 2008;37:430–5.

11.

Menant

Wong

Sturnieks

. Pain and anxiety mediate the relationship between dizziness and falls in older people. J Am Geriatr Soc 2013;61:423–8.

12.

Poole

Treleaven

Jull

The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther 2008;13:317–24.

13.

Uthaikhup

Jull

Sungkarat

. The influence of neck pain on sensorimotor function in the elderly. Arch Gerontol Geriatr 2012;55:667–72.

14.

Vass

Avlund

Hendriksen

. Preventive home visits to older people in Denmark–why, how, by whom, and when? Z Gerontol Geriatr 2007;40:209–16.

15.

Hvid

Strotmeyer

Skjødt

. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults – a randomized controlled trial. Exp Geront 2016;80:51–6.

16.

Dionne

Dunn

Croft

. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 2008;33:95–103.

17.

Delbaere

Mikolaizak

. The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age Ageing 2010;39:210–6.

18.

Bech

Rasmussen

Olsen

. The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord 2001;66:159–64.

19.

Olsen

Jensen

Noerholm

. The internal and external validity of the Major Depression Inventory in measuring severity of depressive states. Psychol Med 2003;33:351–6.

20.

Folstein

McHugh

. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.

21.

MacKenzie

Copp

Shaw

. Brief cognitive screening of the elderly: a comparison of the Mini-Mental State Examination (MMSE), Abbreviated Mental Test (AMT) and Mental Status Questionnaire (MSQ). Psychol Med 1996;26:427–30.

22.

Guralnik

Simonsick

Ferrucci

. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:M85–94.

23.

Abellan van Kan

Rolland

Andrieu

. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging 2009;13:881–9.

24.

Quadri

Tettamanti

Bernasconi

. Lower limb function as predictor of falls and loss of mobility with social repercussions one year after discharge among elderly inpatients. Aging Clin Exp Res 2005;17:82–9.

25.

Rothman

Greenland

. Introduction to stratified analysis. In: Rothman

Lash

Greenland

(eds) Modern epidemiology. Philadelphia, US: Lippincott Williams & Wilkins, 2008, pp.258–82.

26.

Patel

Phelan

Leveille

. High prevalence of falls, fear of falling, and impaired balance in older adults with pain in the United States: findings from the 2011 National Health and Aging Trends Study. J Am Geriatr Soc 2014;62(10):1844–52.

27.

Chou

. Reciprocal relationship between pain and depression in older adults: evidence from the English Longitudinal Study of Ageing. J Affect Disord 2007;102:115–23.

28.

Eggermont

Penninx

Jones

. Depressive symptoms, chronic pain, and falls in older community-dwelling adults: the MOBILIZE Boston Study. J Am Geriatr Soc 2012;60:230–7.

29.

Boudreau

Falla

. Chronic neck pain alters muscle activation patterns to sudden movements. Exp Brain Res 2014;232:2011–20.

30.

Richardson

Bennett

Kenny

. Polypharmacy including falls risk-increasing medications and subsequent falls in community-dwelling middle-aged and older adults. Age Ageing 2014;44(1):90–6.

31.

Ekvall Hansson

Magnusson

. Vestibular asymmetry predicts falls among elderly patients with multi-sensory dizziness. BMC Geriatr 2013;13:77.