257 Chronic pain is associated with mobility impairment and falls among community-dwelling older people: data from TILDA

Abstract Background Chronic pain is prevalent among older people in Ireland and can have a profound impact on health outcomes. The aim of this study is to assess the relationship between chronic pain and mobility impairment and falls risk in a population-representative sample of older people. Methods Participants ≥70 years at TILDA Wave 1 were asked ‘Are you often troubled with pain?’ and if yes, were then asked ‘How bad is it most of the time? Mild, moderate, or severe?’. Mobility was assessed with Timed Up and Go (TUG). Data was collected on falls and unexplained falls (falls not due to a slip/trip, with no apparent cause) within the last 12 months. Linear regression models, reporting β-coefficients, assessed the independent relationship between chronic pain and TUG; logistic regression models, reporting Odds Ratios (OR) and 95% Confidence Intervals (95% CI) assessed the association with falls. Results Over 1/3 of participants reported chronic pain as follows: mild (10%, 221/2,308); moderate (17%, 396/2,308) and severe (10%, 222/2,308). Participants with moderate (TUG: 12.67 [95% CI 11.83–13.51]) and severe chronic pain (TUG 13.98 [95% CI 12.32–15.64]) had a prolonged TUG, compared to those who were pain-free (TUG 10.94 [95% CI 10.61–11.25]). In fully-adjusted linear regression models, both moderate (β = 1.11 [95% CI 0.28–1.93]; p = 0.008) and severe pain (β = 1.63 [95% CI 0.48–2.77]; p = 0.005) were independently associated with prolonged TUG. Participants with chronic pain also had a higher likelihood of total (OR 1.30 [95% CI 1.00–1.6]); p = 0.049) and unexplained falls (OR 1.81 [95% CI 1.18–2.76]; p = 0.006) in fully-adjusted models. Conclusion Chronic pain confers significant limitations on mobility among older people: participants with severe pain take on average 3 seconds longer to complete the TUG. Further, chronic pain is associated with falls, particularly unexplained falls, highlighting the need to assess and treat pain as part of the comprehensive geriatric assessment.