Objectives To identify the frequency of falls, determine the fall-related risk factors and investigate the consequences of falls in RA patients during the 3-year prospective study.
Methods 247 persons were enrolled: 133 RA patients (94% women; mean age 61±11) and 104 controls (96% women; mean age, 62±8). After a detailed clinical assessment (VAS, DAS28, HAQ) fall occurrence in the past 12 months before the enrolment was recorded and risk of falling was assessed by Short Physical Performance Battery (SPPB). Quality of life was measured by EQ-5D. Participants were followed up every 12 months during 3 years by telephone calls or visit to the clinic Outcome measures included fall occurrence, reason for fall, fall location, type and severity of injuries, fractures, use of health services.
Results The fall prevalence during the preceding12-month period was 30.8% (41/133) in RA group and 19.2% (20/104) in control (p<0.05). Frequency of fractures in the past was the same in two groups, but in RA patients they occurred at younger age than in controls (56±11 vs 65±13 years old, p<0.05). PA pts achieved numerically worse results in performing SPPB test, especially in gait speed test and 5-time sit down-to-stand up test (p<0.05) comparing to controls. Among RA patients fallers had significantly higher DAS28, VAS pain, received more high daily dose of glucocoticosteroids (p<0.05). No differences were found in handgrip strength, number of swollen and tender joints of lower limbs, visual acuity. During 3-year follow up period 58 (43.6%) RA pts reported a total of 112 falls with an incidence rate of 42/100 prs-years and 44 (42.3%) controls – 98 falls (34/100 prs-years) (p<0.05). Mean age of RA fallers was less than in control (59±9 vs 66±7, p<0.05). 22 falls in RA pts and 8 – in control were resulted in fractures (p<0.05). Quality of life was not restored throughout the year in RA pts with fractures, even after a wrist fracture vs control (p<0.05).
Conclusions Adults with RA are at high risk of falls and fall-related fractures that reduce the quality of there life. Falls have to be assessed regularly in medical consultations in RA patients regardless of age. RA patients are candidates for earlier preventing falls and fractures programs.
Disclosure of Interest None declared