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Pain and factors related to it constitute serious health problems in the older population. This populationbased cross-sectional study aimed to investigate whether musculoskeletal pain is associated with mobility limitation and whether the relationship between pain and mobility limitation varies according to the use of analgesics among community-dwelling older people. A total of 622 community-dwelling participants aged 75 years and older (mean age 80.4, 74% women) were interviewed about presence and severity of musculoskeletal pain. Self-reported analgesic drug utilization was verified against medical records. Mobility limitation was assessed by the Timed Up & Go test (TUG) time of >13.5 s or inability to perform the test. Logistic regression was used to evaluate the pain-affect associations, with associations expressed as odds ratios with 95% confidence intervals (CI). After adjustment for several covariates, musculoskeletal pain remained independently associated with mobility limitation (odds ratio = 1.83; 95% CI 1.16, 2.89). The risk of mobility limitation was highest among those who reported severe or moderate pain (1.84; 1.13, 3.13) and among those who used analgesics (2.37; 1.37, 4.11). In conclusion, musculoskeletal pain increases the risk for mobility limitation. The present findings underline the importance of the careful assessment and pharmacological and nonpharmacological management of pain in promoting mobility in older age.

Objective: To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain. Design: Three-year geriatric development project with randomized assignment to intervention and control group. Setting: Research centre, community and assisted living facilities. Participants: Seven hundred and eighty-one Finnish persons aged 75–98 years were assigned to an intervention ( n = 404) or control ( n = 377) group. Intervention: A comprehensive geriatric assessment with a multifactorial intervention lasting two years. The intervention included individualized referrals, recommendations, physical activity counselling and supervised resistance training. Measurements: Perceived limitation in walking 400m was gathered annually during the intervention and at the one-year post-intervention follow-up. Results: The proportion of persons with mobility limitation at the beginning, at the two-year intervention and at the one-year post-intervention follow-up was 16%, 15%, 12% and 14%, respectively, in the intervention group. In the control group, the corresponding proportions were 19%, 18%, 23% and 26%. The treatment effect was significant at the end of the two-year intervention (odds ratio 0.82, 95% confidence interval 0.70–0.96, P = 0.013), and at the one-year post-intervention follow-up (0.84, 0.75–0.94, P = 0.002). The parallel positive effect of the intervention on mobility was even greater among persons with musculoskeletal pain. Conclusion: The comprehensive geriatric assessment and individually tailored multifactorial intervention had a positive effect on mobility, underlining their importance in health promotion and disability prevention in older people.

Background and aims: We studied the effects of comprehensive geriatric assessment and multifactorial intervention on physical performance among older people. Methods: In a 3-year geriatric development project with an experimental design, 668 participants aged 75–98 were assigned to intervention (n=348) or control (n=320) groups. The intervention group received comprehensive geriatric assessment with an individually targeted intervention for 2 years. The outcome measures—performance in the Timed Up-and-Go (TUG), 10-meter walking and Berg Balance Scale tests 2 were gathered annually during the intervention and the 1-year follow-up after it. Results: With linear mixed models, over the 2-year intervention period, the intervention group was found to be improved in the balance (p

Background. Balance is among the most important prerequisites for safe and independent mobility. Whether musculoskeletal pain is related to standing balance impairment has received limited attention. The aim of this study was to examine the association of musculoskeletal pain with the control of balance in older people. Methods. A total of 605 participants aged 75 years and older (mean age 80.4, 71 % women) were interviewed about presence and severity of musculoskeletal pain. Balance was measured by a force platform, and impaired balance was defined as a high sway velocity moment or inability to maintain semitandem standing. Results. Musculoskeletal pain was reported by 48% of the participants, of whom majority had moderate to severe pain in lower extremities or back. Participants with moderate to severe musculoskeletal pain swayed more while standing than those without pain. After controlling for age, gender, body mass, chronic diseases, muscle strength, and physical activity, the participants with moderate to severe pain had more than twice (odds ratio 2.33, 95% confidence interval 1.44-3.76) the risk for impaired balance compared with those without pain. Conclusions. The findings demonstrate a direct relationship between the moderate to severe musculoskeletal pain and impaired postural balance. Pain seems to be an important target for the prevention of balance impairment and further mobility limitation among older people.