THU0130 INCIDENCE AND RISK FACTORS OF FALLING IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Rym Fakhfakh, Jguirim Mahbouba, Hibatallah Mosbeh, Abir Dghaies, Grassa Rim, Olfa Jmaa, Saoussen Zrour, Ismail Bejia, Mongi Touzi, Naceur Bergaoui
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> People with rheumatoid arthritis (RA) may be at greater risk of falling than the non-RA population [1]. This increased falls risk may be due to RA disease-related impairments including pain, deformity and decreased muscle strength, as well as reduced functioning such as altered gait and a decline in postural stability. <h3>Objectives:</h3> The aim of this study was to evaluate the prevalence of falls and its association with clinical data, disease-related outcomes and physical performance tests. <h3>Methods:</h3> Cross-sectional study including patients with RA, followed in the Rheumatology Department over a period of 1 month in 2018. The following parameters were evaluated: clinical aspects; fall occurrence in the previous 12 months; pain on a visual analogue scale (VAS); RA disease Activity Score 28 (DAS28)/erythrocyte sedimentation rate (ESR); Functional capacity assessed by the Health Assessment Questionnaire (HAQ); anxiety and depression by the Hospital Anxiety and Depression Scale (HADS) and Physical performance, assessed by 3 tests, the Timed Up and Go (TUG), one leg standing balance (OST) and sternal nudge test (SNT). <h3>Results:</h3> Forty-eight patients were enrolled, the average age was 55.8 ± 13.9 and the sex ratio was 0.14. The average disease duration was 13.49 years ± 9.12. The average DAS28 was 4.63 ± 1.19 and HAQ was 0.77 ± 0.88. Falls were reported by 44.7% of patients: 27.7% had one fall and 17% had ≥ 2 falls. Patients had a fractures history in 10.9% of cases and dislocations in 6.5% of cases. The HAQ (p=0.04) and c reactive protein (p=0.01) was associated with fall history; the other parameters (Gender, number of medications, age, disease activity and physical tests) showed no associations with history of falls. Physical performance was decreased to: 58.4% for TUG test, 61.7% for OST and 36.2% for SNT. The worst performance in physical tests (TUG, OST and SNT) was associated with older age, higher erythrocyte sedimentation rate, higher HAQ, and increased DAS28 (p&lt;0.05). In addition, hips and especially knees involvement was significantly associated with TUG (p=0.03) and OST test (p=0.003). TUG test was significantly associated with depression (p=0.04). The OST test was associated with higher disease duration (p=0.004), VAS (p=0.006) and tender joints (p=0.001). There was no association between number of falls and any of the physical performance tests. <h3>Conclusion:</h3> It was observed that the occurrence of falls is quite common in this population. The occurrence of falls in this sample of rheumatoid arthritis patients bears no relation to disease activity or physical performance tests. But, falls were associated with functional capacity. <h3>Reference:</h3> [1] StanmoreEK,OldhamJ,SkeltonDA,O'Neill T,PillingM,CampbellAJ,etal.Risk factors forfallsinadultswithrheumatoidarthritis:aprospectivestudy. Arthritis CareRes2013;65:1251–8. <h3>Disclosure of Interests:</h3> None declared