Fear-of-falling and associated risk factors in persons with rheumatoid arthritis: a 1 year prospective study

BMC Musculoskeletal Disorders

Mark Pilling¹  Chris Todd²  Emma K. Stanmore³  Jackie Oldham⁴  Dawn A. Skelton⁵  Terence O’Neill⁶ 

[1] Behaviour and Health Research Unit, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, CB2 0SR, Cambridge, UK;School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, M13 9LP, Manchester, UK;School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, M13 9LP, Manchester, UK;Manchester University NHS Foundation Trust, M13 9WL, Manchester, UK;School of Health Sciences, Citylabs, Nelson Street, University of Manchester, M13 9LP, Manchester, UK;School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Rd, G4 0BA, Glasgow, UK;Versus Arthritis Centre for Epidemiology and Centre for Musculoskeletal Research, University of Manchester, M13 9PT, Manchester, UK;Department of Rheumatology, Salford Royal National Health Service Foundation Trust, M6 8HD, Salford, UK;

关键词: Fear-of-falling;    Falls;    Physical function;    Rheumatoid arthritis;    Prospective;   

DOI  :  10.1186/s12891-021-04068-0

来源: Springer

【 摘 要 】

BackgroundFalls, associated injuries and fear-of-falling are common in adults with RA. Fear-of-falling can be a major consequence of, and as debilitating as falling, resulting in a cycle of activity restriction, reduced quality of life, institutionalisation and potentially increase risk of falls. The objective of this study was to examine the relationship between fear-of-falling and risk factors associated with fear-of-falling in adults with rheumatoid arthritis (RA) over a 1 year period.MethodsFive hundred fifty-nine patients with RA were recruited from four outpatient clinics in this prospective cohort study. Baseline assessments included socio-demographic, medical and lifestyle related risk factors. Fall incidence was prospectively obtained monthly using postal cards over a 1 year period. Fear-of-falling was assessed at baseline and 1 year using the Short Falls Efficacy Scale-International (Short FES-I). Logistic regression was used to determine the association between high fear-of-falling (Short FES-I > 11) at baseline (outcome) and a range of putative predictor variables including previous falls, and also baseline factors associated with a high fear-of-falling at follow-up.ResultsFive hundred thirty-five (ninety-six percent) participants (mean age 62.1 yrs.; 18–88 yrs) completed 1 year follow-up and of these, 254 (47%) completed the Short FES-I questionnaire at 1 year. In a multivariate model, a history of multiple falls (OR = 6.08) higher HAQ score (OR = 4.87) and increased time to complete the Chair Stand Test (OR = 1.11) were found to be independent predictors of high fear-of-falling and had an overall classification rate of 87.7%. There were no significant differences found in fear-of-falling at 1 year follow-up in those who reported falls during the study, participant’s baseline fear appeared to predict future fear, regardless of further falls.ConclusionsFear-of-falling is significantly associated with previous falls and predictive of future falls and fear. RA patients would benefit from fall prevention measures whether or not they have previously fallen.

【 授权许可】

CC BY