The quantitative assessment of falling risk in rheumatoid arthritis patients and the determination of the risk factors

Rheumatoid Arthritis (RA) is a chronic inflammatory disease that influence mainly major and minor joints, additionally RA causes to systemic influence and its etiology is not certain. RA is the most common inflammatory joint disease in the world and it influences 1% of the world (1, 2). Falls are a common event in patients with RA. Previous studies found a fall incidence within 1 year 33% and 54% (3-9). About 68% of the patients with RA have an increased risk of falling (7). We planned to evaluate the falling numbers within the last twelve months, fear of falling and falling risk by taking consideration of the studies in which there are the increasing incidence of falling with RA patients. We aimed to detect the relation between the falling risk and indexes such as additional diseases, the clinical assessment parameters in that we are evaluated the disease activity, and the health assessment questionnaire. 100 RA patients who have the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) classification criteria (W/M: 84/16; the average age: 49,46 ±11,11 year) and 50 healthy people (W/M: 19/31; the average age: 34,34 ±12,71 year) were included in our study. The falling risk was defined by portable balance system in participants. In our study it was statistically evaluated that whether falling risk has the relation between the patients' age, gender, pain level, body mass indexes, disease activity, disease severity and accompanied comorbidities or not. HAQ-DI (The Health Assesment Questionnaire Disability Index), DAS-28 (Validation of the 28 Joint Disease Activity Score), CDAI (Clinical Disease Activity Indexes), SDAI (Simple Disease Activity Indexes) ile Falls Efficacy Scale International (FES-I) were performed to participants. When the fear of falling in participants was searched; it was detected that 56% of the patients and 16% of the control group have fear of falling and there were statistically significant differences between the groups (p<0.05). When the tetrax measurement results of the participants were compared, it was detected that the tetrax values of the patients were meanly 58.4228.31 and the tetrax values of the healthy group were meanly 26.0217.12 and there were statistically significant differences between the groups (p<0.05). When the means of the Falls Efficacy Scale in participants were compared; it was detected that the patients have 21.7419.74 score and the healthy group have 11.784.34 score and there were statistically significant differences between the groups (p<0.05). The positive significant relation was detected between the tetrax values of the patients and age, the results of the HAQ-DI, FES, DAS28, DAS28 CRP, CDAI and SDAI (p<0.05). As a result, the falling risk of RA patients was detected higher than healthy population. The high disease activity that is assessed by DAS28, CDAI, SDAI and the high HAQ-DI scores caused the increase in falling risk. Since the high disease activity is related to the increase in falling risk within RA patients, the earliest control time of the disease activity is so important. For this, the necessary medical treatment, behavioral therapies and physical therapy exercises should be performed. Prospectively, there is a need for more studies that are made by the more selected clinical parameter and the more quantitative patients.