title: Rheumatoid arthritis and falls: the influence of disease activity.
abstract: OBJECTIVE
  To examine the correlation between disease activity of RA and the risk of falling.
  
  
  METHODS
  Seventy-eight patients were tested. Disease activity was measured with acute-phase reactants, autoantibodies, swollen and tender joint count (SJC28, TJC28), pain on a visual analogue scale (VAS pain), patient and evaluator global assessment of disease activity (PGA, EGA), HAQ disability index (HAQ-DI), 28-joint DAS (DAS-28) and the clinical and simple disease activity indexes (CDAI, SDAI). The risk of falling was evaluated by a fall assessment consisting of Tinetti test (TIT), timed get up and go test (TUG), chair-rising test (CRT), tandem walk and tandem stand test.
  
  
  RESULTS
  During the last 12 months, 26.9% of the participants reported a fall and 46.2% mentioned the fear of falling. The most evident link [Spearman's correlation (r(s))] with the results of the fall assessment was found in HAQ-DI (CRT: r(s) = 0.523, TUG: r(s) = 0.620, TIT: r(s) = -0.676), CDAI (CRT: r(s) = 0.460, TUG: r(s) = 0.504, TIT: r(s) = -0.472), VAS pain (CRT: r(s) = 0.441, TUG: r(s) = 0.616, TIT: r(s) = -0.548) PGA (CRT: r(s) = 0.473, TUG: r(s) = 0.577, TIT: r(s) = -0.520) and TJC (CRT: r(s) = 0.488, TUG: r(s) = 0.394, TIT: r(s) = -0.385). Patients with higher disease activity achieved poorer results in the fall assessment.
  
  
  CONCLUSIONS
  The strongest correlation with falls was evident for patient-reported outcomes. Pain seems to be the common ground of these parameters. At the same time, disease activity influences pain. The results suggest an increased attention towards the risk of falling with patients of higher levels of disease activity or pain, and physio- or ergotherapeutical interventions as needed.
authors.affiliation: Department of Acute Geriatric Medicine, SMZ Sophienspital, Apollogasse 19, Vienna 1070, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Böhler
authors.forename: Helga
authors.initials: H
authors.lastname: Radner
authors.forename: Michaela
authors.initials: M
authors.lastname: Ernst
authors.forename: Alexa
authors.initials: A
authors.lastname: Binder
authors.forename: Tanja
authors.initials: T
authors.lastname: Stamm
authors.forename: Daniel
authors.initials: D
authors.lastname: Aletaha
authors.forename: Josef S
authors.initials: JS
authors.lastname: Smolen
authors.forename: Marcus
authors.initials: M
authors.lastname: Köller
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000523:psychology; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology; D010147:Pain Measurement; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D055815:Young Adult