Rheumatoid arthritis and falls: the influence of disease activity

Böhler, Christoph; Radner, Helga; Ernst, M.; Binder, Alexa; Stamm, Tanja; Aletaha, Daniel; Smolen, Josef S.; Köller, Marcus

doi:10.1093/rheumatology/kes198

Cited by 61 publications

(50 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the strongest correlation with falls was reported as RA patient-reported outcomes. 13 In our study, we could not find any relationship between fall risk and the age of the patient or disease duration. In previous studies investigating the incidence and risk factors for falls in people with RA, age was assessed as a risk factor for falls, but no significant association was found between age and fall frequency.…”

Section: Discussioncontrasting

confidence: 67%

“…2,[14][15][16] However, in another study, steroid intake did not influence the fall risk assessment results in patients with RA. 13 Since the previous data was based on a different disease, namely RA, different drugs, and different fall risk assessments, it may be difficult to consider these results together with our study. However, it seems to be reasonable that drugs may be considered as one of the possible factors related to fall risk in these patients.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Fall Risk and Related Factors in Systemic Lupus Erythematosus

Melikoğlu

Bağcıer

2017

Arch Rheumatol

View full text Add to dashboard Cite

Objectives: This study aims to determine the fall risk in systemic lupus erythematosus (SLE) patients with an objective computerized technique and to evaluate the potential related risk factors for falls in these patients. Patients and methods: A total of 48 female patients (mean age 37.8±12.6 years; range 18 to 65 years) with SLE and 30 female controls (mean age 39.1±15.7 years; range 19 to 66 years) were included. Age, disease duration, anamnesis of falls, fear of falling, and drugs used were recorded. Disease activity (measured with SLE disease activity index Safety of Estrogens in Lupus Erythematosus National Assessment modification) and damage (measured with Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) were evaluated. For the evaluation of fall efficacy, we used the Falls Efficacy Scale International. Fall risk analysis was performed by using a computerized posturography device. Results: Seven patients (15%) had anamnesis of falls during the last 12 months, whereas only one control (3%) had this anamnesis (p=0.042). Fear of falling was reported by 40% of the patients and 30% of the controls (p=0.042). Falls Efficacy Scale International scores were found to be higher in patients than in controls (p=0.042). With the computerized system used, higher fall risk results were recorded in patients than in controls (59.3±29.5 and 35.8±26.9, respectively; p<0.001). Low, moderate, and high fall risks were recorded as 31%, 15%, and 54% in the patients, respectively, and as 53%, 23%, and 23% in the controls, respectively. Low, moderate and high fall risk distribution was also worse in patients than in the controls (p=0.030). No significant correlation was found between fall risk and the other factors evaluated, except Falls Efficacy Scale International, which was significantly correlated with both fall risk assessment and fall risk category in the patients (r=0.311, p=0.031). Conclusion: Fall risk was found to be higher in SLE patients than in controls. The higher fall risk in these patients seems to be affected by the disease itself rather than its other characteristics. Future studies investigating the possible coexisting balance problems in SLE may contribute to the management of the disease.

show abstract

Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 94%

Fall Risk and Related Factors in Systemic Lupus Erythematosus

Melikoğlu

Bağcıer

2017

Arch Rheumatol

View full text Add to dashboard Cite

show abstract

“…The incidence of falls in this sample of RA patients was high (48.8%) compared to that found in the literature, which shows ranges from 14.3 to 54% in retrospective studies and from 18.8 to 50% in prospective studies [4][5][6][7][8][9][11][12][13][14][15][16][17][18][19]. The incidence of falls observed was also high compared to that of noninstitutionalized elderly individuals, which ranges from 15.9 to 56.3% [2].…”

Section: Discussionmentioning

confidence: 58%

“…Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease of joint predominance, with a high prevalence of falls occurring in 14.3 to 54% of patients over a one-year period, which are high values compared to the general population [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. This increased risk of falls may be due to pain, edema, deformities, loss of muscle strength or gait changes, and prospective studies have shown associations with altered balance, use of psychotropic medications, fear of falling and previous falls [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Characterization of falls in adults with established rheumatoid arthritis and associated factors

2018

View full text Add to dashboard Cite

Background: Rheumatoid arthritis patients may have an increased risk of falls due to changes caused by the disease such as muscle weakness, joint impairment, reduced mobility and postural instability. The aim of this study was to prospectively analyze the occurrence of falls in RA patients and its risk factors. Methods: A cohort of 86 RA patients were assessed over 1 year for disease activity using the Disease Activity Score (DAS-28), for functionality using the Health Assessment Questionnaire (HAQ), for the characterization of falls and for the use of medications, and they were subjected to the Berg Balance Scale (Berg), Timed Up and Go (TUG), 6-Minute Walk (6MWT) and Short Physical Performance Battery (SPPB) tests. The Kolmogorov-Smirnov, Spearman's correlation, Student's t, Mann-Whitney and chi-square tests were performed with a significance level of P ≤ 0.05. Results: A total of 86 patients were evaluated, of which 48.8% had at least one fall and 75.6% reported having a fear of falling. No association of falls with age, disease duration, functional capacity, disease activity or physical performance was found. Patients with poorer performance in the physical tests had more functional impairment, higher disease activity and more advanced age. No differences in physical or functional performance, disease activity, gender or fear of falling were found between fallers and non-fallers; only a greater amount of medications used was found in the group of fallers. Conclusions: The occurrence of falls was high and associated with a previous history of falls and polypharmacy, with no association with disease activity or duration, functional capacity, physical performance, age or gender.

show abstract

“…Little is known about factors associated with falls and fear of falling among middle aged and older adults with RA. Previous studies have reported FOF incidence between 10 and 60% in this population [11][12][13][14] and falls incidence between 10 and 50% [4,12,[14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 90%

Fear of falling, foot disability and disease activity in patients with rheumatoid arthritis

Bahha¹,

Amine²,

Erraoui³

et al. 2017

Rheumatol Orthop Med

View full text Add to dashboard Cite

Objective: To evaluate fear of falling (FOF) in patients with established rheumatoid arthritis (RA) and its relationship with disease activity and foot disability. Materials and methods:A cross-sectional study that included patients with RA. We collected the following data: age, sex, duration of disease, foot pain assessed by the Visual Analogue Scale (VAS), HAQ disability index (HAQ-DI). Disease activity was measured with swollen and tender joint count (SJC28, TJC28), patient and evaluator global assessment of disease activity (PGA, EGA), 28-joint DAS (DAS-28) and the clinical and simple disease activity indexes (CDAI, SDAI). Fear of falling was assessed by Falls Efficacy Scale-International (FES-I). Foot disability was measured using the Leeds Foot Impact Scale (LFIS). Correlations were used to assess the relationship between fear of falling and disease activity, foot pain, impairment and disability. Multiple linear regression analysis was used to explore risk factors associated with FOF.Results: Thirty-three patients were included. The mean age was 49.3 ± 10.5 years with female predominance (n = 29 (87.9%)). The mean disease duration was 9.0 ± 7.4 years. The mean VAS foot pain was 5.5 ± 2.4. The mean FES-I score was 37.4 ± 15.1 and 69.7% (n = 23) of patients had significant fear of falling. FES-I was significantly correlated with foot impairment (r=0.66; p<0.0001) and disability (r=0.80; p <0.0001).Evaluating the relationship between fear of falling and disease activity, FES-I was significantly correlated with TJC28 (r = 0.52, p = 0. Conclusion:This study has demonstrated the importance of the relationship between FOF and disease activity, foot impairment and disability in patients with RA. Others studies are needed to increase the awareness around FOF and foot disability among practitioners.

show abstract

Rheumatoid arthritis and falls: the influence of disease activity

Cited by 61 publications

References 33 publications

Fall Risk and Related Factors in Systemic Lupus Erythematosus

Fall Risk and Related Factors in Systemic Lupus Erythematosus

Characterization of falls in adults with established rheumatoid arthritis and associated factors

Fear of falling, foot disability and disease activity in patients with rheumatoid arthritis

Contact Info

Product

Resources

About