Abstract

Comorbid pain and falls among Chinese older adults: The association, healthcare utilization and the role of physical functioning

Sha Li¹, Haocen Wang², Yang Yang¹, Yao Meng¹, Junhua Zhu¹, Yun Jiang³, Rumei Yang¹ (1)School of Nursing, Nanjing Medical University, (2)Department of Health and Kinesiology, Texas A&M University, (3)School of Nursing, University of Michigan

APHA 2022 Annual Meeting and Expo

Background: Pain and falls are two critical disabling conditions that are presumably associated with physical functioning. Older adults can potentially experience discordance between self-reported (aka. subjective) and performance-based (aka. objective) physical functioning. This study aimed to explore 1) the associations between pain and falls among Chinese older adults, 2) the associations between pain-fall status and healthcare utilization, and 3) the role of subjective or objective physical functioning in contributing to pain intensity and falls.
Methods: The sample (N=4,461, aged 60-95 years) was derived from the 2011-2012 baseline survey of the China Health and Retirement Longitudinal Study. We applied logistic, negative binomial, and linear models with the adjustment of demographic variables.
Results: The prevalence of pain, falls, and comorbid pain-fall were 36%, 20%, and 11%, respectively. Pain intensity was significantly associated with falls (Odds Ratio, OR=1.28, p<0.001). More number of times receiving inpatient care and doctor visits were reported in groups of pain-only (Incidence Rate Ratio, IRR=1.55, p<0.001; IRR=2.09, p<0.001, respectively), fall-only (IRR=1.60, p<0.001; IRR=1.93, p<0.001, respectively), and comorbid pain-fall (IRR=1.55, p=0.010; IRR=1.82, p<0.001, respectively) than those without pain and falls. The fall-only group had higher hospitalization costs than those without pain and falls (b=761.71, p=0.007). Subjective but not objective physical functioning was associated with pain (OR=1.31, p=0.002; OR=1.15, p=0.020, respectively) and fall (b=0.17, p=0.005; b=0.19, p<0.001, respectively).
Conclusions: Pain is related to falls, and both can induce more healthcare utilization. The associations of subjective physical functioning with pain and falls suggest that more attention should be paid to self-reported physical status when designing pain-fall preventive strategies.