Association of disease activity and health assessment with the risk of falls in RA patients: Are DAS-28 and HAQ-DI scores related with the risk of falls assessed in RA patients?

Abstract

Introduction/ObjectivesThe prevalence of falls in RA patients ranges from 14.3% to 54%. Some tools for assessing falls risk predict this in the elderly population. As RA usually begins at a younger age, it would be worth exploring the risk of falls in this age set of patients. Downton index>3 and a Tinetti scale<18 are predictive of fall risk. The study aims to determine the association of RA disease activity and health assessment with falls risk. Materials and methodsObservational, cross-sectional study in RA patients. Demographics, DAS28, HAQ-DI medications, Tinetti scale, and Downton index were obtained. ResultsWe included 108 patients, 98 (90.7%) were women. Patients’ mean age was 52.5±10.8 years. Median DAS-28 and HAQ-DI scores were 3.6 and .81. Sixty (55.6%) patients had previous falls. We observed a positive significant correlation between the Downton index and patient's age (rho=.44, p<.001), RA diagnosis time (rho=.23, p=.014), RA activity (DAS-28 score) (rho=.61, p<.001), and a HAQ-DI score (rho=.709, p<.001). Overall, the total Tinetti evaluation scale was significantly correlated with age (rho=−.36, p<.001), time since RA diagnosis (rho=−.20, p=.031), RA activity (DAS-28 score) (rho=−.77, p<.001), and HAQ-DI score (rho=−.835, p<.001). After a multivariate analysis, we found that for a high risk of falls by Downton score, age>52 years had an OR 7.5 (95% CI, 3.1–17.7; p=.001), a DAS-28>3.5 had an OR 9.1 (95% CI, 3.7–22.1; p=.02), and a HAD-QI>.94 had an OR 27.9 (95% CI, 7.1–100.9; p=.001). For a Tinetti score that predicts risk of falls, a HAD-QI>1.44 had an OR 1.8 (95% CI, 1.28–2.52; p=.001). ConclusionsThere is a correlation between DAS-28 and HAD-QI scores and risk of falls in younger RA patients. The DAS-28 and HAD-QI can predict falls risk using surrogate scales. The risk of falls is an assessment that should be considered RA patients.