Background Risk of vertebral fractures is increased in patients with ankylosing spondylitis (AS). The underlying mechanisms for the elevated fracture risk might be associated with bone and fall-related risks.
Objectives The aim of this study was to evaluate the risk of falls and to determine the factors that increase the risk of falls in AS patients.
Methods Eighty-nine women, 217 men, a total of 306 AS patients with a mean age of 40.1 ± 11.5 from 9 different centers in Turkey were included in the study. Patients were questioned regarding history of falls within the last one year. Their demographics, disease characteristics including Bath AS Disease Activity Index (BASDAI), Bath AS Metrology Index (BASMI), Bath AS Functional Index (BASFI), AS Quality of Life Index (ASQoL), and risk factors for falls including Vitamin D levels and Short Physical Performance Battery (SPPB) Test results were recorded.
Results Forty (13%) out of 306 patients reported at least one fall in the recent one year. Statistically significant differences were found between the patients with and without a history of falls regarding age (p=0,001), disease duration (p=0,001), history of fractures (p=0.035), fear of falls (p=0,000), hip involvement (p=0,032), BASMI (p=0,002), BASFI (p=0,000), and SPPB (p=0,000). No significant correlation were found between number of falls and gender, morning stiffness, polypharmacy, knee involvement, ankle involvement, usage of antidepressants or myorelaxants, AS related days of sick leave, BASDAI, ASQoL, sedimentation, CRP, and Vitamin D levels (p>0,05 for all parameters). Statistically significant correlations were found between number of falls and age (R=0,117, p=0,041), disease duration (R=0,160, p=0,005), AS related lost job (R=0,140, p=0,014), fear of falling (R=0,316, p=0,000), hip involvement (R=0,112, p=0,05), BASMI (R=0,234, p=0,000), BASFI (R=0,244, p=0,000), and SPPB (R=0,183, p=0,006).
Conclusions The annual incidence of falls was higher among AS patients than that of normal population. Age, longstanding disease, hip joint involvement, fear of falls, history of fractures, reduced mobility, decreased function, impaired balance were found to be the factors that increase the risk of falls in AS patients.
References Geusens P, Vosse D, Van der Linden S: Osteoporosis and vertebral fractures in ankylosing spondylitis. Curr Opin Rheumatol 2007, 19:335-339.
Sambrook PN, Geusens P: The epidemiology of osteoporosis and fractures in ankylosing spondylitis. Ther Adv Musculoskel Dis 2012, 4(4): 287-292.
Disclosure of Interest None Declared