Background Rheumatoid arthritis (RA) is a risk factor of osteoporosis. RA patients have impaired levels of physical activity and postural stability, so we can suggest that they have increased risk of falls. Osteoporosis and falls lead to fractures, which contribute significantly to morbidity and mortality of these patients.
Objectives To study the frequency of falls, define related risk factors and quality of life in RA patients.
Methods We performed a case-control study of RA patients (n=94 and mean age 62,5±7,1) and people without RA (n=92 and mean age 63,3±7,1). The participants completed risk factors questionnaire, Health Assessment Questionnaire (HAQ), EuroQol-5D (EQ-5D) and performed Short Physical Performance Battery (SPPB). Disease activity and intensity of pain were assessed in RA patients with DAS28 and VAS. Bone density (BMD) was measured in lumbar spine and proximal hip using dual-energy X-ray absorptiometry (Hologic Discovery A) in all participants.
Results More RA patients had a history of previous fall during 1 year before the study compared with controls (31% vs 17%, p=0.03). RA patients had atraumatic fractures at younger age than control (55±15 vs 66±20 years old), they were more fearful of falling and had abnormal SPPB test (p<0.05), especially in performing gait speed test and chair stand test (p<0.05), but no difference among 2 groups in performing balance test. RA woman complained on insomnia more often than control (p<0.05). Among RA patients fallers did not differ from non-fallers in age, disease duration, use of medications (except glucocoticosteroids), visual acuity. RA fallers had significantly higher DAS28, pain intensity, received more high daily dose of glucocoticosteroids (p=0.04), and had less EQ-5D. They less consumed supplements of calcium and vitamin D (p<0.05). Low BMD at least in one of measured area was found out in 48% RA persons. RA patients with osteoporosis fell significantly often than subjects without osteoporosis (p<0.01) and rarely spent time outdoors, especially during the winter. Fearing of falling negative correlated with EQ-5D, more patients noted moderate or severe depression.
Conclusions Our results shows that RA patients had a high risk of falling, especially in subjects with osteoporosis, so it is necessary to consider these patients as candidates for treatment and rehabilitation programs to reduce risk of falling and fractures.
Disclosure of Interest None Declared