One in three people with rheumatoid arthritis, regardless of their age, will fall once or more times a year, according to a new University of Manchester study.
The research, funded by medical research charity Arthritis Research UK, shows those who have fallen once are at much greater risk of falling again due to previous injuries and an increased fear of falling. Over half of the falls studied resulted in injuries such as pain and bruising and one in 10 falls caused a serious head injury or fracture.
The Manchester study is the largest and first of its kind to give a full picture of falls in people with rheumatoid arthritis – an incurable condition which causes joint damage and muscle pain for around half a million people in the UK.
The study found the strongest risk factor is a person’s fall history. People are three times more likely to experience further falls within a year of their first fall. Swollen and tender limb joints, the use of psychotropic medication for problems such as anxiety, depression and sleeping problems as well as fatigue were identified as the risk factors health visitors and professionals should assess people with the condition for. This would highlight those at risk who may need to be referred to a falls clinic or for physiotherapy as part of an individualised falls prevention programme.
Emma Stanmore, lead researcher of the study based in the University’s School of Nursing, Midwifery and Social Work, said: “Our study successfully shows adults with rheumatoid arthritis are at a high risk of repeated falls. Increased fear of falling and injuries can lead to sedentary behaviour which in turn decreases muscle strength – one of the most common factors that contribute to falls.
“We’ve shown that falls in people with the condition aren’t just random – falls can be predicted and possibly prevented by assessing and treating a number of risk factors in adults with the condition.
“We hope our findings will be used for further research to develop a falls prevention programme which could include exercises to target lower limb muscle strength and challenge balance along with a review of medication.”
Professor Alan Silman, medical director at Arthritis Research UK, said: “Falls are a big problem to people with rheumatoid arthritis and to our public health system. Falls and injuries lead to a reduction in the quality of life for many and can lead to loss of independence, isolation and depression, as well as posing a public health cost challenge.
“Any clues which help us to better understand how to predict and prevent falls are incredibly important, so this is a really exciting piece of research.”
This work was published in Arthritis Care and Research. The one year study looked at fall prevalence, consequences and risk factors in 559 people with rheumatoid arthritis between the ages of 18-88.
Source: Arthritis Research UK & The University of Manchester