ArticleBMC geriatrics2025
Activity of daily living impairment mediates the relationship between pain and falls in Chinese older adults: a cohort study.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Machine learning-based cross-sectional exploration of depression-chronic pain associations in chronic respiratory disease patients.BMC geriatrics · 2026Observational
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5 authors.
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Abstract
backgroundFalls impose a substantial disease burden on older adults, yet whether ADL impairment mediates the pain-falls pathway remains unclear. This study investigates whether ADL impairment acts as a mediator in the relationship between pain and incident falls among Chinese community-dwelling older adults.
methodsWe conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS) on respondents aged ≥ 60 years. Baseline and follow-up information was obtained through structured interviews. Logistic regression first quantified the pairwise associations among pain, ADL impairment, and falls. Subsequently, bootstrap-based mediation analysis was applied to test whether ADL impairment mediated the pain-falls relationship, restricting the model to variates that were significant in all three logistic regressions.
resultsA total of 6,280 participants was included in the analysis. Pain frequency (PF) (OR = 1.16, 95% CI: 1.10 to 1.22) and number of pain sites (NPS) (OR = 1.22, 95% CI: 1.13 to 1.31) were significantly associated with falls. PF (OR = 1.56, 95% CI: 1.49 to 1.63) and NPS (OR = 1.96, 95% CI: 1.83 to 2.11) were significantly associated with ADL impairment. ADL impairment was significantly associated with falls. Mediation analysis revealed that ADL impairment mediated the association between PF (mediation effect = 6.06e-03, proportion = 22.47%) and falls, and between NPS (mediation effect = 1.10e-02, proportion = 25.01%) and falls. Specifically, the mediating effect of impairments in dressing, bathing and toileting were significant.
conclusionOur study illuminates the mechanistic cascade from pain to falls via ADL impairment and offer concrete, modifiable targets for fall-prevention programs tailored to Chinese community-dwelling older adults. Coupling effective pain management with targeted support for dressing, bathing, and toileting is likely to curtail fall risk and enhance quality of life in older adults.
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