Risk factors for falls and bone fractures in patients with rheumatoid arthritis

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.