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Published in: Rheumatology International 10/2013

01-10-2013 | Original Article

Frequency and predictors for falls in the ambulatory patients with rheumatoid arthritis: a longitudinal prospective study

Authors: Derya Bugdayci, Nurdan Paker, Aylin Rezvani, Nur Kesiktas, Ozlem Yilmaz, Melike Sahin, Nurhan Ince

Published in: Rheumatology International | Issue 10/2013

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Abstract

The aim of this multicentre study is to investigate the incidence and risk factors for falls in ambulatory rheumatoid arthritis (RA) patients. One hundred and eighty-five ambulatory RA patients who have been followed up in 3 different centres were included in study. Patients were a part of Turkish League Against Rheumatism-Follow-up Program. All patients were evaluated at the baseline in terms of demographic features, falls history in the last year, disease-specific characteristics and co-morbidities. Functional status was evaluated by chair stand test with five repetitions and heel–toe walking. Erythrocyte sedimentation rate and CRP values were measured. Study patients were followed by the three monthly visits during a year. Patients were asked to fill the fall diary and/or call the doctor when a fall happens. The features of falls were recorded to the files at the time of the fall. The mean age was 56.7 ± 11.4 years. Four patients were drop out the study. Thirty-four patients fell and 2 had fractures during 1 year. Falls were found to be correlated with age, visual analogue score for pain, previous falls, use of assistive devices for ambulation, use of two or more medications and ability to do heel–toe walking. In the multivariate regression analysis, previous falls and use of assistive device for ambulation were found to be independent risk factors for falls (p = 0.004 OR 3.3 95 % CI 1.5–7.4, p = 0.001 OR 6.2 95 % CI 2–19.1). Fall history in the last year and using an assistive ambulation device are the predictors of the falls.
Literature
1.
go back to reference Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Eng J Med 319:1701–1707CrossRef Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Eng J Med 319:1701–1707CrossRef
2.
go back to reference Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls: a prospective study. JAMA 261:2663–2668PubMedCrossRef Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls: a prospective study. JAMA 261:2663–2668PubMedCrossRef
3.
go back to reference Leveille SG, Bean J, Bandeen-Roche K, Jones R, Hochberg M, Guralnik JM (2002) Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc 50:671–678PubMedCrossRef Leveille SG, Bean J, Bandeen-Roche K, Jones R, Hochberg M, Guralnik JM (2002) Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc 50:671–678PubMedCrossRef
4.
go back to reference Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O’Brien LA, Hoffman S, Kaplan F (1991) Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med 324(19):1326–1331PubMedCrossRef Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O’Brien LA, Hoffman S, Kaplan F (1991) Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med 324(19):1326–1331PubMedCrossRef
5.
go back to reference Tinetti ME, Speechley M (1998) The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol 53:112–119 Tinetti ME, Speechley M (1998) The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol 53:112–119
6.
go back to reference Symmons D, Turner G, Webb G, Asten P, Barett E, Lunt M, Scott D, Silman A (2002) The prevalence of rheumatoid arthritis in the United Kingdom: new estimates for a new century. Rheumatology (Oxford) 41:793–800CrossRef Symmons D, Turner G, Webb G, Asten P, Barett E, Lunt M, Scott D, Silman A (2002) The prevalence of rheumatoid arthritis in the United Kingdom: new estimates for a new century. Rheumatology (Oxford) 41:793–800CrossRef
7.
go back to reference Akar S, Birlik M, Gürler O, Sarı I, Onen F, Manisalı M et al (2004) The prevalence of rheumatoid arthritis in an urban population of Izmir-Turkey. Clin Exp Rheumatol 22:416–420PubMed Akar S, Birlik M, Gürler O, Sarı I, Onen F, Manisalı M et al (2004) The prevalence of rheumatoid arthritis in an urban population of Izmir-Turkey. Clin Exp Rheumatol 22:416–420PubMed
8.
go back to reference Smolen JS, Landewe R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C et al (2010) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 69:964–975PubMedCrossRef Smolen JS, Landewe R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C et al (2010) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 69:964–975PubMedCrossRef
9.
go back to reference Kaz Kaz H, Johnsin D, Kerry S, Chinappen U, Tweed K, Patel S (2004) Fall- related risk factors and osteoporosis in woman with rheumatoid arthritis. Rheumatology (Oxford) 43:1267–1271CrossRef Kaz Kaz H, Johnsin D, Kerry S, Chinappen U, Tweed K, Patel S (2004) Fall- related risk factors and osteoporosis in woman with rheumatoid arthritis. Rheumatology (Oxford) 43:1267–1271CrossRef
10.
go back to reference Oswald AE, Pye SR, O’Neill TW, Bunn D, Gaffney K, Marshall T, Silman AJ, Symmons DP (2006) Prevalence and associated factors for falls in women with established inflammatory polyarthritis. J Rheumatol 33:690–694PubMed Oswald AE, Pye SR, O’Neill TW, Bunn D, Gaffney K, Marshall T, Silman AJ, Symmons DP (2006) Prevalence and associated factors for falls in women with established inflammatory polyarthritis. J Rheumatol 33:690–694PubMed
11.
go back to reference Jamison M, Neuberger GB, Miller PA (2003) Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum 49:673–680PubMedCrossRef Jamison M, Neuberger GB, Miller PA (2003) Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum 49:673–680PubMedCrossRef
12.
go back to reference Armstrong C, Swarbrick CM, Pye SR, O’Neill TW (2005) Occurence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis 64:1602–1604PubMedCrossRef Armstrong C, Swarbrick CM, Pye SR, O’Neill TW (2005) Occurence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis 64:1602–1604PubMedCrossRef
13.
go back to reference Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R (2010) Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporos Int 21:1825–1833PubMedCrossRef Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R (2010) Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporos Int 21:1825–1833PubMedCrossRef
14.
go back to reference Smulders E, Schreven C, Weedesteyn, van den Hoogen FHJ, Van Lankveld W (2009) Fall incidence and fall risk factors in people with rheumatoid arthritis. Ann Rheum Dis 68:1795–1796PubMedCrossRef Smulders E, Schreven C, Weedesteyn, van den Hoogen FHJ, Van Lankveld W (2009) Fall incidence and fall risk factors in people with rheumatoid arthritis. Ann Rheum Dis 68:1795–1796PubMedCrossRef
15.
go back to reference Yamagiva K, Iijama S, Furuya T, Ikai T, Inoue E, Taniguchi A, Momohara S, Yamanaka H (2011) Incidence of falls and fear of falling in Japanese patients with rheumatoid arthritis. Mod Rheumatol 21(1):51–56CrossRef Yamagiva K, Iijama S, Furuya T, Ikai T, Inoue E, Taniguchi A, Momohara S, Yamanaka H (2011) Incidence of falls and fear of falling in Japanese patients with rheumatoid arthritis. Mod Rheumatol 21(1):51–56CrossRef
16.
go back to reference Fessel KD, Nevitt MC (1997) Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis. Arthritis Care Res 10:222–228PubMedCrossRef Fessel KD, Nevitt MC (1997) Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis. Arthritis Care Res 10:222–228PubMedCrossRef
17.
go back to reference Huusko TM, Korpela M, Karppi P, Avikainen V, Kautianien H, Sulkava R (2001) Threefold increased risk of hip fractures with rheumatoid arthritis in central Finland. Ann Rheum Dis 60:521–522PubMedCrossRef Huusko TM, Korpela M, Karppi P, Avikainen V, Kautianien H, Sulkava R (2001) Threefold increased risk of hip fractures with rheumatoid arthritis in central Finland. Ann Rheum Dis 60:521–522PubMedCrossRef
18.
go back to reference Vis M, Haavardsholm A, Boyesen P, Haugeberg G, Uhlig T, Hoff M, Woolf A, Dijkmans B, Lems W, Kvien TK (2011) High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5 year follow-up study in postmenopausal woman in rheumatoid arthritis. Osteoporos Int 22:2413–2419PubMedCrossRef Vis M, Haavardsholm A, Boyesen P, Haugeberg G, Uhlig T, Hoff M, Woolf A, Dijkmans B, Lems W, Kvien TK (2011) High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5 year follow-up study in postmenopausal woman in rheumatoid arthritis. Osteoporos Int 22:2413–2419PubMedCrossRef
19.
go back to reference Nampei A, Hashimoto J, Koyanagi J, Ono T, Hashimoto H, Tsumaki N, Tomita T, Sugamoto K, Nishimoto N, Ochi T, Yoshikawa H (2008) Characteristics of fracture and related factors in patients with rheumatoid arthritis. Mod Rheumatol 18:170–176PubMedCrossRef Nampei A, Hashimoto J, Koyanagi J, Ono T, Hashimoto H, Tsumaki N, Tomita T, Sugamoto K, Nishimoto N, Ochi T, Yoshikawa H (2008) Characteristics of fracture and related factors in patients with rheumatoid arthritis. Mod Rheumatol 18:170–176PubMedCrossRef
20.
go back to reference Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvein TK (2000) Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis. Arthritis Rheum 43:522–530PubMedCrossRef Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvein TK (2000) Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis. Arthritis Rheum 43:522–530PubMedCrossRef
21.
go back to reference Paker N, Soy D, Kesiktas N, Bardak A, Erbil M (2004) Osteoporosis in the patients with long duration rheumatoid arthritis (Uzun süreli romatoid artriti olan hastalarda osteoporoz). Turkish J Phys Med Rehabil 50:29–30 Paker N, Soy D, Kesiktas N, Bardak A, Erbil M (2004) Osteoporosis in the patients with long duration rheumatoid arthritis (Uzun süreli romatoid artriti olan hastalarda osteoporoz). Turkish J Phys Med Rehabil 50:29–30
22.
go back to reference Furuya T, Kotake S, Inoue E, Nanke Y, Yago T, Kobashiwa T et al (2007) Risk factor associated with incident clinical vertebral and non-vertebral fractures in Japanese women with rheumatoid arthritis: a prospective 54-month observational study. J Rheumatol 34:303–310PubMed Furuya T, Kotake S, Inoue E, Nanke Y, Yago T, Kobashiwa T et al (2007) Risk factor associated with incident clinical vertebral and non-vertebral fractures in Japanese women with rheumatoid arthritis: a prospective 54-month observational study. J Rheumatol 34:303–310PubMed
23.
go back to reference Cummings SR, Nevitt MC, Kidd S (1998) Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 36:613–616 Cummings SR, Nevitt MC, Kidd S (1998) Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 36:613–616
24.
go back to reference Arnett FC, Edworthy SM, Bloch DA, Mc Shane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1998) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324CrossRef Arnett FC, Edworthy SM, Bloch DA, Mc Shane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1998) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324CrossRef
25.
go back to reference Prevoo ML, Van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48PubMedCrossRef Prevoo ML, Van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48PubMedCrossRef
26.
go back to reference Pincus T, Summey JA, Soraci SA, Wallston KA, Hummon NP (1983) Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assesment Questionnaire. Arthritis Rheum 26:1346–1353PubMedCrossRef Pincus T, Summey JA, Soraci SA, Wallston KA, Hummon NP (1983) Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assesment Questionnaire. Arthritis Rheum 26:1346–1353PubMedCrossRef
27.
go back to reference Dargent-Molina P, Favier F, Grandjean H, Baudoin C, Schott AM, Hausherr E, Meunier PJ for EPIDOS Group (1996) Fall-related factors and risk of hip fracture: EPIDOS prospective study. Lancet 348:145–49 Dargent-Molina P, Favier F, Grandjean H, Baudoin C, Schott AM, Hausherr E, Meunier PJ for EPIDOS Group (1996) Fall-related factors and risk of hip fracture: EPIDOS prospective study. Lancet 348:145–49
28.
29.
go back to reference Hooyman JR, Melton LJ, Nelson AM, O’Fallon WM, Riggs BL (1984) Fractures after rheumatoid arthritis. Arthritis Rheum 27:1353–1361PubMedCrossRef Hooyman JR, Melton LJ, Nelson AM, O’Fallon WM, Riggs BL (1984) Fractures after rheumatoid arthritis. Arthritis Rheum 27:1353–1361PubMedCrossRef
30.
go back to reference Furuya T, Hosoi T, Saito S, Inoue E, Tanuguchi A, Momohara S, Yamanaka H (2011) Fracture risk assessment and osteoporosis treatment disparities in 3.970 Japanese patients with rheumatoid arthritis. Clin Rheumatol 30:1105–1111PubMedCrossRef Furuya T, Hosoi T, Saito S, Inoue E, Tanuguchi A, Momohara S, Yamanaka H (2011) Fracture risk assessment and osteoporosis treatment disparities in 3.970 Japanese patients with rheumatoid arthritis. Clin Rheumatol 30:1105–1111PubMedCrossRef
Metadata
Title
Frequency and predictors for falls in the ambulatory patients with rheumatoid arthritis: a longitudinal prospective study
Authors
Derya Bugdayci
Nurdan Paker
Aylin Rezvani
Nur Kesiktas
Ozlem Yilmaz
Melike Sahin
Nurhan Ince
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International / Issue 10/2013
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-013-2757-5

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