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: 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 (OA).

Design: This prospective longitudinal cohort study included older adults with or at risk of knee OA. 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 months. Multisite pain was categorized into the following four categories: no pain, 1-site, 2-sites, ≥3-sites.

Results: This study included 2585 older adults. Baseline 2-sites (Odds Ratio [OR] 1.50, p = 0.018) and ≥ 3-sites (OR 1.89, p < 0.001) were significantly associated with increased risk of fall over time compared to no pain sites. Baseline 2-sites (Incidence Rate Ratio [IRR] 1.44, p = 0.024) and ≥ 3-sites (IRR 1.73, p < 0.001) were significantly associated with an increased number of falls over time. Only ≥3-sites were associated with the recurrent falls (OR 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 seven years of follow-up.