Fall Incidence and Outcomes of Falls in a Prospective Study of Adults With Rheumatoid Arthritis

OBJECTIVES: To determine the incidence of falls and to investigate the consequences of falls in adults with rheumatoid arthritis. METHODS: 559 community dwelling adults with RA, aged 18 to 88 years (mean age 62; 69% female) participated in this prospective cohort study. Patients were followed for 1 year after a detailed clinical assessment, using monthly falls calendars and follow-up telephone calls. Follow-up took place in participants' usual place of residence in the Northwest of England. Outcome measures included fall occurrence, reason for fall, type and severity of injuries, fractures, fall location, lie-times, use of health services and functional ability. RESULTS: 535 participants followed for 1 year had a total of 598 falls. 36.4% participants (95% CI 32% to 41%) reported falling during 1 year follow-up with an incidence rate of 1313/1000 person-years at risk or 1.11 falls per person. Age and gender were not associated with falls. Over one third of the falls were reportedly caused by hips, knees or ankle joints giving way. Over half of all the falls resulted in moderate injuries, including head injuries (n=27) and fractures (n=26). Treatment by general practitioners or other health professionals was required for 15.0% of falls and emergency services were required after 8.8% of falls. CONCLUSIONS: These results indicate that adults with RA are at high risk of falls and fall-related injuries, fractures and head injuries. Strategies to prevent falls in adults with RA must be prioritised to reduce falls and fall-related injuries, and fractures. � 2012 by the American College of Rheumatology.