Association of chronic pain and slower processing speed with falls in community-dwelling older adults

Honda, Hiroya; Ishizaka, Nanako; Sasaki, Sakura; Hirase, Tatsuya

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Ann Geriatr Med Res > Accepted Articles

Original Article

DOI: https://doi.org/10.4235/agmr.26.0079 [Accepted]
Published online September 3, 2026.

Association of chronic pain and slower processing speed with falls in community-dwelling older adults

Hiroya Honda¹

, Nanako Ishizaka^1,2, Sakura Sasaki¹, Tatsuya Hirase¹

¹Division of Physical Therapy Science, Graduate Course of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
²Department of Rehabilitation, Fuchinobe General Hospital, Sagamihara, Kanagawa, Japan

Correspondence: Tatsuya Hirase,
Email: hirase-rx7@kuhs.ac.jp

Received: 19 April 2026 • Revised: 25 June 2026 • Accepted: 31 August 2026

Abstract

Background
Falls in older adults are a major public health concern. Chronic pain and slower processing speed are risk factors for falls; however, their combined effect on falls remains unclear. In this study, we aimed to assess whether the coexistence of chronic pain and slower processing speed was associated with falls in community-dwelling older adults.
Methods
This cross-sectional study included 320 older adults who participated in a community-based health survey. Chronic pain was defined as pain persisting or recurring for more than 3 months. Processing speed was assessed by the Digit Symbol Substitution Test; slower processing speed was defined as an age-adjusted Z-score ≤ −1.0. The participants were categorized into four groups based on the presence of chronic pain and slower processing speed. Logistic regression analysis was performed to evaluate the association between group status and falls in the past year.
Results
Of the 320 participants, 60 (18.8%) reported at least one fall in the previous year. After adjustment for age, sex, body mass index, the Timed Up and Go test, and the Falls Efficacy Scale–International, the coexistence of chronic pain and slower processing speed was significantly associated with falls compared to that with neither condition (odds ratio [OR]=3.203, 95% confidence interval [CI]=1.036–9.901, p=0.043).
Conclusion
The coexistence of chronic pain and slower processing speed was associated with an increased risk of falls in community-dwelling older adults. These findings may help refine fall risk stratification and inform fall prevention strategies considering chronic pain and processing speed.

Key Words: Accidental falls, Chronic pain, Cognitive dysfunction, Aged