RA Patients Who Take a Spill

Rheumatoid arthritis patients more likely to fall if they have fallen in the last year

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) From pain and fatigue to joint damage, the symptoms of rheumatoid arthritis can make it hard for patients to move around. These symptoms may even lead them to trip, stumble and tumble over.

According to the authors of a new study, patients with rheumatoid arthritis have a higher risk of falling. So researchers wanted to identify the main reasons why these patients are more likely to fall.

Study results showed that falling multiple times in the previous year was the biggest predictor of falling again among adults with rheumatoid arthritis.

Other factors – including swollen and tender lower limb joints, the use of certain medications and fatigue – also predicted risk of future falls.

"Tell your rheumatologist if you've fallen recently."

For their recent research, Emma K. Stanmore, PhD, MRes, DN, RN, of the Manchester Academic Health Science Centre in the United Kingdom, and colleagues investigated the relationship between potential risk factors and falls in adults with rheumatoid arthritis.

These potential risk factors included poor lower limb muscle strength, lack of stability of posture, higher number of swollen and tender joints, functional status, history of falling, fear of falling, pain, fatigue, and medication and steroid use.

The study involved 559 men and women with rheumatoid arthritis between the ages of 18 and 88. Of these participants, 535 were followed for one year.

Results showed that patients with a history of multiple falls in the previous year had 5.3 times higher odds of falling again, compared to those without a history of falling.

Other risk factors for falling included higher counts of swollen and tender lower limb joints, the use of psychotropic medication (medications for particular mental health issues) and fatigue.

According to the authors, these three factors are "modifiable risk factors," meaning that they can be addressed and changed.

The odds of falling were 1.7 times higher among patients with higher counts of swollen and tender lower limb joints compared to those with lower counts. 

The odds of falling were 1.13 times higher among those experiencing fatigue.

Patients using psychotropic medications had 1.8 times higher odds of falling compared to those who were not using such medications.

"There are many medications, including psychotropic drugs, that are considered 'fall risk drugs.' When I counsel patients that have any gait issues, I would warn them about these drugs to make sure they are being very cautious when getting around," Mark Newberry, PharmD, owner of Tarrytown Pharmacy in Austin, Texas, explained to dailyRx News.

"Patients need to be encouraged to let their pharmacist know if they do have mobility issues of any kind. These are not always apparent during counseling sessions and we should be aware of all conditions to make sure the therapy is appropriate for our patients."

Study results also showed that neither age nor gender was associated with the higher risk of falling.

In conclusion, the authors wrote, "Adults with rheumatoid arthritis are at high risk of falls. In clinical practice, high risk falls patients with rheumatoid arthritis can be identified by asking whether patients have fallen in the past year."

The study was published in Arthritis Care & Research. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 10, 2013
Last Updated:
August 14, 2013