RESEARCH - Incidence and risk factors of falling in ambulatory patients with RA: a prospective 1-year study

February 16, 2011

Osteoporos Int. 2010 Nov;21(11):1825-33. Epub 2010 Jan 30.

Incidence and risk factors of falling in ambulatory patients with

rheumatoid arthritis: a prospective 1-year study.

Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R.

Department of Orthopedic Surgery, Faculty of Medicine, Tottori

University, Yonago, Tottori, 683-8504, Japan.

Abstract

A prospective 1-year study showed that fall incidence was 50% in women

with rheumatoid arthritis. Multivariate analysis identified swollen

joint count, use of antihypertensives or diuretics, one-leg standing

time, and sway area measured by stabilometer as significant parameters

associated with falls.

INTRODUCTION: Patients with rheumatoid arthritis (RA) may be at

increased risk of falling because they frequently experience muscle

weakness and stiff or painful joints. The aim of this study was to use

a prospective design to determine the incidence of falls and their

risk factors in women with RA.

METHODS: Eighty-four women aged 50 and over who had RA were enrolled.

The mean age was 64.1 years. We evaluated postural stability, physical

performance related to falls, disease activity, muscle volume, and

bone density. The occurrence of falls was assessed every month for 1

year. Among 84 patients, 80 completed a 1-year observation.

RESULTS: Forty patients (50.0%) reported one or more falls, and two of

them (5.0%) had fractures during the follow-up period. The fall group

had more swollen joints and took more antihypertensives and/or

diuretics. The fall group also had lower postural stability and tended

to have reduced physical performance. The one-leg standing time was

shorter, and the step-up-and-down test score was lower in the fall

group. The sway area was larger in the fall group.

DISCUSSION: Multiple logistic regression analysis identified that

number of swollen joints, use of antihypertensives or diuretics,

shorter time standing on one foot, and the sway area were the most

significant parameters associated with falls.

CONCLUSION: We concluded that fall rates in RA patients were higher

than in the general population and that balance impairment or side

effects of drugs may play a role in increasing the risk of falls.

PMID: 20119662

Not an MD

Recommended Posts