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ORIGINAL PAPER
Risk factors for falls and bone fractures in patients with rheumatoid arthritis
Online publication date: 2010-05-14
Reumatologia 2010;48(2):98-103
KEYWORDS
ABSTRACT
Objectives: To determine the one-year prevalence of falls and fractures in patients with rheumatoid arthritis (RA) and to evaluate the influence of potential risk factors on the occurrence of falls and bone fractures.
Methods: The study enrolled 186 patients with RA (all fulfilling the ACR criteria). Patients were invited to complete an interviewer-assisted questionnaire concerning falls and fractures in the previous 12 months and the health assessment questionnaire (HAQ). Patients’ history, clinical records and physical examination of 68 joints were assessed.
Results: All patients completed the questionnaires (167 [89.8%] women and 19 men). The mean age was 58.5 ±13.8, the mean duration of RA was 14.4 ±10.7 years and the mean HAQ score was 1.36 ±0.76. Eighty patients (43%) reported falling one or more times. Among the “fallers”, 28 patients (35%) sustained one or more fractures as a result of a fall. Dizziness (odds ratio [OR] = 2.68), use of antidepressant (OR = 2.56) and antihypertensive drugs (OR = 2.27), foot deformities (OR = 3.14) and elevated HAQ scores (OR = 2.08) were noted as major risk factors for falls. There was no important increase in the frequency of falls with age or duration of RA. Among patients with fractures osteoporosis (t-score < –2.5) (OR = 4.70), antihypertensive medications (OR = 4.98), foot deformity (OR = 4.82), dizziness (OR = 3.30) and high HAQ scores (OR = 3.12) were identified as significant risk factors for fractures.
Conclusions: Falls are common in RA patients. Foot deformities, dizziness, use of antihypertensive drugs and high HAQ scores were identified as major risk factors for falls and fractures.
Methods: The study enrolled 186 patients with RA (all fulfilling the ACR criteria). Patients were invited to complete an interviewer-assisted questionnaire concerning falls and fractures in the previous 12 months and the health assessment questionnaire (HAQ). Patients’ history, clinical records and physical examination of 68 joints were assessed.
Results: All patients completed the questionnaires (167 [89.8%] women and 19 men). The mean age was 58.5 ±13.8, the mean duration of RA was 14.4 ±10.7 years and the mean HAQ score was 1.36 ±0.76. Eighty patients (43%) reported falling one or more times. Among the “fallers”, 28 patients (35%) sustained one or more fractures as a result of a fall. Dizziness (odds ratio [OR] = 2.68), use of antidepressant (OR = 2.56) and antihypertensive drugs (OR = 2.27), foot deformities (OR = 3.14) and elevated HAQ scores (OR = 2.08) were noted as major risk factors for falls. There was no important increase in the frequency of falls with age or duration of RA. Among patients with fractures osteoporosis (t-score < –2.5) (OR = 4.70), antihypertensive medications (OR = 4.98), foot deformity (OR = 4.82), dizziness (OR = 3.30) and high HAQ scores (OR = 3.12) were identified as significant risk factors for fractures.
Conclusions: Falls are common in RA patients. Foot deformities, dizziness, use of antihypertensive drugs and high HAQ scores were identified as major risk factors for falls and fractures.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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