Association of low back and knee pain with falls in Japanese community-dwelling older adults: A 3-year prospective cohort study.

AIM: To examine whether the chronicity and intensity of low back pain (LBP) or knee pain (KP) was associated with the occurrence of falls among a community-dwelling older population. METHODS: This was a community-based 3-year prospective cohort study. In 2009, baseline questionnaires were mailed to 3080 randomly selected residents aged 60-79 years; 2534 residents (82.3%) responded to the baseline survey, and 1- and 3-year follow-up surveys were subsequently mailed to them. The data for 1890 respondents who had no falls in the past year at baseline were analyzed. Associations between pain status (chronicity, intensity and persistence) and the occurrence of falls were analyzed by multivariable-adjusted logistic regression. RESULTS: A total of 197 (13.6%) participants had at least one fall during 12 months at 3-year follow up; of those, 68 (4.8%) had multiple falls, and 65 (4.5%) resulted in an injury. Chronicity and intensity of LBP were associated with injurious falls (P for trend = 0.033 and P for linearity = 0.041, respectively), and KP was associated with at least one fall (P for trend = 0.021 and P for linearity = 0.040, respectively). In addition, participants who had chronic pain persistently at both baseline and 1-year follow up had a higher risk of falls (LBP for injurious falls; adjusted odd ratio 2.46, 95% confidence interval 1.08-5.63, KP for at least one fall; adjusted odd ratio 2.39, 95% confidence interval 1.29-4.44), compared with those who had no pain at both time-points. CONCLUSIONS: LBP and KP chronicity, intensity and persistence of chronic pain were associated with a greater risk of falls in older adults. Geriatr Gerontol Int 2017; 17: 875-884.

Association between knee pain and gait speed decline in rural Japanese community-dwelling older adults: 1-year prospective cohort study.

AIM: The present study examined whether knee pain was associated with decline in maximum gait speed (MGS) in a rural mountainous region. METHODS: This was a population-based 1-year prospective cohort study. A total of 658 men and women aged 60 years and older participated in the baseline survey in 2006, and 400 individuals participated in the follow-up survey in 2007. We compared the incidence of meaningful decline in gait speed (≥0.1 m/s) in older adults with different knee pain levels (none, mild, severe), estimating incidence rate ratio (IRR) by multivariable-adjusted Poisson regression model. RESULTS: Meaningful decline in MGS presented in 24.3% of participants, especially in men (30.3%). Baseline knee pain level was significantly related to meaningful decline in MGS after adjustment of potential confounders (IRR 1.79 for mild pain, 1.84 for severe pain; P for trend <0.01). In sensitivity analyses with change in MGS as the continuous variable, the association was not significant, but a similar negative association with knee pain was confirmed (mild pain ß = -0.040, severe pain ß = -0.088; P for trend = 0.104). In addition, older adults with knee pain at both baseline and follow up had a higher risk of meaningful decline in MGS (IRR 2.33, 95% CI 1.59-3.40) compared with those who had no pain at baseline or follow up. CONCLUSIONS: Knee pain was associated with a decline in gait speed at 1-year follow up. Prevention and treatment of knee pain might be important for suppression of decline in physical function in older adults.

Association between musculoskeletal pain and trips or falls in rural Japanese community-dwelling older adults: a cross-sectional study.

AIM: The present study examined whether low back pain (LBP) and knee pain (KP) are associated with trips and falls in rural Japanese community-dwelling older adults. METHODS: A population-based cross-sectional survey of community-dwelling older adults was carried out in Unnan City, Shimane Prefecture, in Japan. A total of 499 men and women aged 60 years and older living in the community were recruited from 2008 to 2010. The main outcome measures were self-rated recent trip frequency and self-reported experience of falls in the past year. RESULTS: Trips and falls presented in 44.0% and 15.9% of participants, respectively. LBP was not associated with trips, but was significantly associated with falls: severe pain versus single fall (odds ratio [OR] 2.51, 95% confidence interval [CI] 1.04-6.03); and severe pain versus multiple falls (OR 11.09, 95% CI 2.41-51.10). KP was significantly associated with trips: mild pain versus trips (OR 1.81, 95% CI 1.20-2.72); mild pain versus multiple falls (OR 4.47, 95% CI 1.21-16.50); severe pain versus trips (OR 3.83, 95% CI 1.82-8.04); and severe pain versus multiple falls (OR 7.26, 95% CI 1.51-34.86). Participants with both pain sites were associated with trips (OR 2.44, 95% CI 1.45-4.12) and multiple falls (OR 10.79, 95% CI 1.33-87.19). CONCLUSIONS: Severe LBP was associated with single and multiple falls, whereas KP was associated with trips and multiple falls, irrespective of severity of pain. In addition, participants with both pain types were associated with trips and multiple falls.

A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial.

BACKGROUND: We aimed to evaluate the effectiveness of a community-wide campaign (CWC) for promoting physical activity in middle-aged and elderly people. METHODS: A cluster randomized controlled trial (RCT) with a community as the unit of randomization was performed using a population-based random-sampled evaluation by self-administered questionnaires in the city of Unnan, Shimane Prefecture, Japan. The evaluation sample included 6000 residents aged 40 to 79 years. We randomly allocated nine communities to the intervention group and three to the control group. The intervention was a CWC from 2009 to 2010 to promote physical activity, and it comprised information, education, and support delivery. The primary outcome was a change in engaging in regular aerobic, flexibility, and/or muscle-strengthening activities evaluated at the individual level. RESULTS: In total, 4414 residents aged 40-79 years responded to a self-administered questionnaire (73.6% response rate). Awareness of the CWC was 79% in the intervention group. Awareness and knowledge were significantly different between the intervention and control groups, although there were no significant differences in belief and intention. The 1-year CWC did not significantly promote the recommended level of physical activity (adjusted odds ratio: 0.97; 95% confidence interval: 0.84-1.14). CONCLUSIONS: This cluster RCT showed that the CWC did not promote physical activity in 1 year. Significant differences were observed in awareness and knowledge between intervention and control groups as short-term impacts of the campaign. TRIAL REGISTRATION: UMIN-CTR UMIN000002683.

Differences in association of walking for recreation and for transport with maximum walking speed in an elderly Japanese community population.

BACKGROUND: Physical activity contributes to maintaining functional ability later in life. Specific relationships between walking for particular purposes (eg, recreation or transport) and functional ability are not clear. It is useful for planning health promotion strategies to clarify whether walking time for recreation, or walking time for transport has the stronger relationship with maximum walking speed (MWS), a determinant of functional ability later in life in the elderly. METHODS: A cross-sectional survey was conducted in 2007 using a sample of 372 community-dwelling elderly people aged 60 to 87 years in Mitoya Town, Unnan City, rural Japan. Associations with MWS were examined for self-reported weekly times of walking for recreation and for transport using multiple linear regression analyses. RESULTS: Both in men and women, walking time for recreation was significantly associated with MWS after controlling for age, height, weight, hip and knee pain, and a number of chronic diseases (men: ß = 0.18, P = .024; women: ß = 0.17, P < .01). However, walking time for transport was not significantly associated with MWS (men: ß = -0.094, P = .24; women: ß = -0.040, P = .50). CONCLUSIONS: Walking for recreation may contribute to maintaining functional abilities such as MWS in the elderly.