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

Emma Stanmore (Corresponding), Jacqueline Oldham, Dawn A Skelton, Terence O'Neill, Chris Todd

Research output: Contribution to journalArticlepeer-review

Abstract

Background Falls, 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. Methods 559 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. Results 535 (96%) 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 one year follow-up in those who reported falls during the study, participant’s baseline fear appeared to predict future fear, regardless of further falls. Conclusions Fear-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.
Original languageEnglish
Article number260
JournalBMC Musculoskeletal Disorders
Volume22
Issue number1
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Falls
  • Fear-of-falling
  • Physical function
  • Prospective
  • Rheumatoid arthritis

Research Beacons, Institutes and Platforms

  • Manchester Institute for Collaborative Research on Ageing

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