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Letters | March 24 2010

Chronic Pain and Risk of Falls in Older Adults

Sylvie Mesrine, MD; Marie-Christine Boutron-Ruault, MD, PhD; Françoise Clavel-Chapelon, PhD

JAMA. 2010;303(12):1147-1149. doi:10.1001/jama.2010.323.

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To the Editor: In their prospective cohort study, Dr Leveille and colleagues¹ described an association between chronic pain and risk of falls in older adults. They discussed several mechanisms that might explain this association, including “local joint pathology, neuromuscular effects of pain, and central mechanisms, whereby pain interferes with cognition or executive function.”

An additional potential mechanism is that vitamin D deficiency may mediate this association. Vitamin D deficiency has been associated with higher risk of falls,²^- 3 and symptoms associated with hypovitaminosis D include diffuse or migratory pain affecting several sites.⁴ If vitamin D status was assessed in the population studied by Leveille et al, it would be interesting to investigate whether adjustment for 25-hydroxyvitamin D plasma levels modifies the association between chronic musculoskeletal pain and occurrence of falls.

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March 24, 2010

Chronic Pain and Risk of Falls in Older Adults

Scott T. Wilber, MD, MPH; Ashley F. Sullivan, MS, MPH; Carlos A. Camargo, MD, DrPH

JAMA. 2010;303(12):1147-1149. doi:10.1001/jama.2010.324.

March 24, 2010

Chronic Pain and Risk of Falls in Older Adults—Reply

Suzanne G. Leveille, PhD, RN; Dan K. Kiely, MPH; Douglas P. Kiel, MD

JAMA. 2010;303(12):1147-1149. doi:10.1001/jama.2010.325.

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Mesrine S, Boutron-Ruault M, Clavel-Chapelon F. Chronic Pain and Risk of Falls in Older Adults. JAMA. 2010;303(12):1147-1149. doi:10.1001/jama.2010.323.

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