Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study.
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.


BACKGROUND
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.


CONCLUSIONS
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.


CONCLUSIONS
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.
Hayashibara
M
M
Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, 683-8504, Japan. akimasa_nariko@yahoo.ac.jp
Hagino
H
H
Katagiri
H
H
Okano
T
T
Okada
J
J
Teshima
R
R
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D015519:Bone Density / Q000502:physiology; D004232:Diuretics / Q000009:adverse effects; D004734:Energy Metabolism / Q000502:physiology; D004812:Epidemiologic Methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000473:pathology; D004856:Postural Balance; D012678:Sensation Disorders / Q000209:etiology; D016138:Walking / Q000502:physiology
D000959:Antihypertensive Agents; D004232:Diuretics