Statements in this report should not be construed as endorsement by Arthritis Research UK or the Wellcome Trust Clinical Research Facility, Manchester.
Risk Factors for Falls in Adults With Rheumatoid Arthritis: A Prospective Study†
Version of Record online: 26 JUL 2013
Copyright © 2013 The Authors. Arthritis Care & Research is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Arthritis Care & Research
Volume 65, Issue 8, pages 1251–1258, August 2013
How to Cite
Stanmore, E. K., Oldham, J., Skelton, D. A., O'Neill, T., Pilling, M., Campbell, A. J. and Todd, C. (2013), Risk Factors for Falls in Adults With Rheumatoid Arthritis: A Prospective Study. Arthritis Care Res, 65: 1251–1258. doi: 10.1002/acr.21987
- Issue online: 26 JUL 2013
- Version of Record online: 26 JUL 2013
- Accepted manuscript online: 22 FEB 2013 10:50AM EST
- Manuscript Accepted: 13 FEB 2013
- Manuscript Received: 14 FEB 2012
- Arthritis Research UK Allied Health Professional Fellowship. Grant Number: 18010
- Wellcome Trust Clinical Research Facility, Manchester. Grant Number: 06834
To investigate the association between potential risk factors and falls in community-dwelling adults with rheumatoid arthritis (RA).
We followed patients for 1 year of followup in a prospective cohort study with monthly falls calendars and telephone calls. Lower extremity muscle strength, postural stability, number of swollen and tender joints, functional status, history of falling, fear of falling, pain, fatigue, medication, and use of steroids were assessed as risk factors for falls.
A total of 386 women and 173 men with RA (n = 559) ages 18–88 years completed baseline assessments and 535 participants (96%) completed 1-year followup. Bivariate logistic regression showed that falls risk was not associated with age or sex. Multivariate logistic regression revealed that a history of multiple falls in the previous 12 months was the most significant predictive risk factor (odds ratio [OR] 5.3, 95% confidence interval [95% CI] 2.3–12.3). The most significant modifiable risk factors were swollen and tender lower extremity joints (OR 1.7, 95% CI 1.1–2.7), psychotropic medication (OR 1.8, 95% CI 1.1–3.1), and fatigue (OR 1.13, 95% CI 1.02–1.2).
Adults with RA are at high risk of falls. In clinical practice, high-risk fall patients with RA can be identified by asking whether patients have fallen in the past year. Important risk factors highlighted in this study include swollen and tender lower extremity joints, fatigue, and use of psychotropic medications.