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/Objectives

The 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 methods

Observational, cross-sectional study in RA patients. Demographics, DAS28, HAQ-DI medications, Tinetti scale, and Downton index were obtained.

Results

We 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).

Conclusions

There 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.