Evaluation of Risk Factors for Falls in Patients with Rheumatoid Arthritis

Mikoś, Marcin; Kucharska, Ewa; Lulek, Anna Maria; Kłosiński, Michał; Batko, Bogdan

doi:10.12659/msm.921862

Cited by 13 publications

(16 citation statements)

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“…This observation supports previous prospective research which identified self-reported physical activity and mobility as risk factors for falls [12,15]. Furthermore, retrospective studies confirmed the association of HAQ with falls [13,46]. A retrospective study by Armstrong et al [30] demonstrated that two of eight domains (walking and chair rising) were associated with fall history.…”

Section: Discussionsupporting

confidence: 81%

“…Only two other prospective studies reported lower incidence rates of 10.1% [12] and 18.3% [44]. Further retrospective studies described incidence rates between 27 and 54% [13,14,30,[45][46][47][48], which are notably higher than the results of this study. However, retrospective studies are known to be more imprecise [49].…”

Section: Discussioncontrasting

confidence: 77%

“…Nevertheless, age was an independent risk factor for falls in this study. The majority of studies with RA patients have found no association of age and falls [5,13,45,50]. This is surprising, given the fact that cohorts of healthy subjects showed a strong association between the parameters age and falls [51]; thus, is widely accepted as a risk factor for falls from the age of 65 years onwards [52].…”

Section: Discussionmentioning

confidence: 99%

“…As the original study focused on the prevalence of sarcopenia in RA, medication [5], comorbidities [48] and foot deformities [13,72] which are known to increase fall risk were not documented in the study. In particular, foot deformities in patients with RA have a major impact on balance, muscle activity, and strength of the lower limb.…”

Section: Limitationsmentioning

confidence: 99%

“…Rheumatic disease-specific risk factors for falls can be classified as physiological, pharmacological, extrinsic and measure of disease activity [5]. In particular, structural changes such as joint disorders (pain, swollen joints) [12] and deformities [13], reduced postural control [14] and reduced muscle strength [15] were identified as potential physiological risk factors. The Disease Activity Score (DAS28), a clinical measure for disease activity, is also associated with falls [15].…”

Section: Introductionmentioning

confidence: 99%

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Association between sarcopenia, physical performance and falls in patients with rheumatoid arthritis: a 1-year prospective study

Wiegmann

Armbrecht

Borucki

et al. 2021

BMC Musculoskelet Disord

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Background Patients with rheumatoid arthritis (RA) are at increased risk of falls and fractures. Sarcopenia occurs more frequently in RA patients due to the inflammatory processes. Early diagnosis and prevention programmes are essential to avoid serious complications. The present study aims to identify risk factors for falls related to sarcopenia and physical performance. Methods In a 1-year prospective study, a total of 289 patients with RA, ages 24–85 years, were followed using quarterly fall diaries to report falls. At the baseline, medical data such as RA disease duration and Disease Activity Score (DAS28CRP) were collected. Self-reported disability was assessed using the Health Assessment Questionnaire (HAQ). Appendicular skeletal mass was determined by Dual X-ray-Absorptiometry (DXA). Physical performance was evaluated by handgrip strength, gait speed, chair rise test, Short Physical Performance Battery, and FICSIT-4. Muscle mechanography was measured with the Leonardo Mechanograph®. Sarcopenia was assessed according to established definitions by the European Working Group on Sarcopenia in Older People (EWGSOP2) and The Foundation for the National Institutes of Health (FNIH). Univariate and multiple logistic regression analysis were used to explore associations with falling. Receiver-operating characteristics (ROC) were performed, and the area under the curve is reported. Results A total of 238 subjects with RA completed the 1-year follow-up, 48 (20.2%) experienced at least one fall during the observational period. No association was found between sarcopenia and prospective falls. Age (OR = 1.04, CI 1.01–1.07), HAQ (OR = 1.62, 1.1–2.38), and low FICSIT-4 score (OR = 2.38, 1.13–5.0) showed significant associations with falls. Conclusions In clinical practice, a fall assessment including age, self-reported activities of daily life and a physical performance measure can identify RA patients at risk of falling. Trial registration The study has been registered at the German Clinical Trials Register and the WHO International Clinical Trials Registry Platform (ICTRP) since 16 March 2017 (DRKS00011873).

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