Skip to main content

Advertisement

SpringerLink
Log in

Associated factors for falls and fear of falling in Japanese patients with rheumatoid arthritis

  • Brief Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The objective of this is to determine factors associated with falls in Japanese patients with rheumatoid arthritis (RA). Among the patients who participated in a single-institute-based prospective observational cohort study of patients with RA, namely, Institute of Rheumatology Rheumatoid Arthritis, 4,996 (male 765, female 4231, median age 60 years) responded to questions related to falls during the previous 6 months in April or May 2008. Logistic regression was used to determine the association between variables and falls. Five hundred and five (10.1%), 110 (2.2%), and 958 patients (19.2%) reported at least one fall, multiple falls, and fear of falling, respectively. Those who fell tended to report incident fractures during the same 6 months compared to those who did not (14.7% versus 1.1%, P < 0.001). In multivariate models, Japanese health assessment questionnaire (HAQ) scores (odds ratios (OR) 1.52, 2.49, and 3.88), tender joint counts (OR 1.39, 1.72, and 1.36), patient-reported visual analog scale for general health (OR 1.08, 1.16, and 1.20), and body mass index (OR 1.05, 1.08, and 1.04) were associated (P < 0.05) with at least one fall, multiple falls, and fear of falling, respectively. Other clinical variables and medications were also associated with falls and fear of falling. HAQ disability score, tender joint counts, and impaired general health appear to be associated with falls in Japanese patients with RA, as previously reported for patients of other ethnicities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cooper C, Coupland C, Mitchell M (1995) Rheumatoid arthritis, corticosteroid therapy and hip fracture. Ann Rheum Dis 54:49–52

    Article  PubMed  CAS  Google Scholar 

  2. Hooyman JR, Melton LJ 3rd, Nelson AM, O'Fallon WM, Riggs BL (1984) Fractures after rheumatoid arthritis. A population-based study. Arthritis Rheum 27:1353–1361

    Article  PubMed  CAS  Google Scholar 

  3. Huusko TM, Korpela M, Karppi P, Avikainen V, Kautiainen H, Sulkava R (2001) Threefold increased risk of hip fractures with rheumatoid arthritis in Central Finland. Ann Rheum Dis 60:521–522

    Article  PubMed  CAS  Google Scholar 

  4. Orstavik RE, Haugeberg G, Mowinckel P, Hoiseth A, Uhlig T, Falch JA, Halse JI, McCloskey E, Kvien TK (2004) Vertebral deformities in rheumatoid arthritis: a comparison with population-based controls. Arch Intern Med 164:420–425

    Article  PubMed  Google Scholar 

  5. Kaz Kaz H, Johnson D, Kerry S, Chinappen U, Tweed K, Patel S (2004) Fall-related risk factors and osteoporosis in women with rheumatoid arthritis. Rheumatology (Oxford) 43:1267–1271

    Article  CAS  Google Scholar 

  6. Yamanaka H, Tohma S (2006) Potential impact of observational cohort studies in Japan on rheumatoid arthritis research and practice. Mod Rheumatol 16:75–76

    Article  PubMed  Google Scholar 

  7. Furuya T, Kotake S, Inoue E, Nanke Y, Yago T, Kobashigawa T, Ichikawa N, Tanaka E, Momohara S, Nakajima A et al (2007) Risk factors associated with incident clinical vertebral and nonvertebral fractures in Japanese women with rheumatoid arthritis: a prospective 54-month observational study. J Rheumatol 34:303–310

    PubMed  Google Scholar 

  8. Furuya T, Urano T, Ikari K, Kotake S, Inoue S, Hara M, Momohara S, Kamatani N, Yamanaka H (2009) A1330V polymorphism of low-density lipoprotein receptor-related protein 5 gene and self-reported incident fractures in Japanese female patients with rheumatoid arthritis. Mod Rheumatol 19:140–146

    Article  PubMed  CAS  Google Scholar 

  9. Urano W, Furuya T, Inoue E, Taniguchi A, Urano T, Kotake S, Sekita C, Inoue S, Hara M, Momohara S, et al (2009) Associations between methotrexate treatment and methylenetetrahydrofolate reductase gene polymorphisms with incident fractures in Japanese female rheumatoid arthritis patients. J Bone Miner Metab, in press

  10. Furuya T, Kotake S, Inoue E, Nanke Y, Yago T, Hara M, Tomatsu T, Kamatani N, Yamanaka H (2008) Risk factors associated with incident fractures in Japanese men with rheumatoid arthritis: a prospective observational cohort study. J Bone Miner Metab 26:499–505

    PubMed  Google Scholar 

  11. Fessel KD, Nevitt MC (1997) Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis. Arthritis Care Res 10:222–228

    Article  PubMed  CAS  Google Scholar 

  12. Oswald AE, Pye SR, O'Neill TW, Bunn D, Gaffney K, Marshall T, Silman AJ, Symmons DP (2006) Prevalence and associated factors for falls in women with established inflammatory polyarthritis. J Rheumatol 33:690–694

    PubMed  Google Scholar 

  13. Armstrong C, Swarbrick CM, Pye SR, O'Neill TW (2005) Occurrence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis 64:1602–1604

    Article  PubMed  CAS  Google Scholar 

  14. Jamison M, Neuberger GB, Miller PA (2003) Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum 49:673–680

    Article  PubMed  Google Scholar 

  15. Matsuda Y, Singh G, Yamanaka H, Tanaka E, Urano W, Taniguchi A, Saito T, Hara M, Tomatsu T, Kamatani N (2003) Validation of a Japanese version of the Stanford Health Assessment Questionnaire in 3, 763 patients with rheumatoid arthritis. Arthritis Rheum 49:784–788

    Article  PubMed  Google Scholar 

  16. Momohara S, Inoue E, Ikari K, Kawamura K, Tsukahara S, Mochizuki T, Toki H, Miyawaki M, Saito S, Hara M et al (2007) Risk factors for total knee arthroplasty in rheumatoid arthritis. Mod Rheumatol 17:476–480

    Article  PubMed  CAS  Google Scholar 

  17. Momohara S, Inoue E, Ikari K, Tsukahara S, Kawamura K, Toki H, Hara M, Kamatani N, Yamanaka H, Tomatsu T (2008) Risk factors for wrist surgery in rheumatoid arthritis. Clin Rheumatol 27:1387–1391

    Article  PubMed  Google Scholar 

  18. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  19. Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48

    Article  PubMed  CAS  Google Scholar 

  20. Fries JF, Spitz PW, Young DY (1982) The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. J Rheumatol 9:789–793

    PubMed  CAS  Google Scholar 

  21. Davis JW, Ross PD, Nevitt MC, Wasnich RD (1999) Risk factors for falls and for serious injuries on falling among older Japanese women in Hawaii. J Am Geriatr Soc 47:792–798

    PubMed  CAS  Google Scholar 

  22. Chen JS, Simpson JM, March LM, Cameron ID, Cumming RG, Lord SR, Seibel MJ, Sambrook PN (2008) Risk factors for fracture following a fall among older people in residential care facilities in Australia. J Am Geriatr Soc 56:2020–2026

    Article  PubMed  Google Scholar 

  23. Richardson JK (2002) Factors associated with falls in older patients with diffuse polyneuropathy. J Am Geriatr Soc 50:1767–1773

    Article  PubMed  Google Scholar 

  24. Volpato S, Leveille SG, Blaum C, Fried LP, Guralnik JM (2005) Risk factors for falls in older disabled women with diabetes: the women's health and aging study. J Gerontol A Biol Sci Med Sci 60:1539–1545

    PubMed  Google Scholar 

  25. No authors listed (2001) Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 49:664–672

    Google Scholar 

Download references

Acknowledgements

We thank all members of the Institute of Rheumatology, Tokyo Women's Medical University for the successful management of the IORRA cohort. This study was supported by a research grant from 36 pharmaceutical companies for the large observational cohort study of RA at the Institute of Rheumatology, Tokyo Women's Medical University. This work was also partly supported by a grant from the Japanese Osteoporosis Foundation.

Disclosures

None.

Author information

Authors and Affiliations

  1. Institute of Rheumatology, Tokyo Women’s Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan

    Takefumi Furuya, Kiyotaka Yamagiwa, Eisuke Inoue, Atuo Taniguchi, Shigeki Momohara & Hisashi Yamanaka

  2. Department of Rehabilitation, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Tetsuo Ikai

Authors
  1. Takefumi Furuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiyotaka Yamagiwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tetsuo Ikai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eisuke Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Atuo Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shigeki Momohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hisashi Yamanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takefumi Furuya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Furuya, T., Yamagiwa, K., Ikai, T. et al. Associated factors for falls and fear of falling in Japanese patients with rheumatoid arthritis. Clin Rheumatol 28, 1325–1330 (2009). https://doi.org/10.1007/s10067-009-1229-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-009-1229-5

Keywords

Search

Navigation