Patients with AS may be at risk for, in fear of falling
Patients with ankylosing spondylitis may be at a higher risk for falls and fractures, and some patients may experience fear of falling, according to study findings.
Twelve researchers from nine centers across six provinces in Turkey participating in the Activity Program scientific group conducted a study of 306 patients with ankylosing spondylitis (AS). Patients’ mean age 40.1 years, and 217 of the patients included in the study were men.
Patients were evaluated using the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI) and the Short Physical Performance Battery (SPPB), which includes a 4-minute walking test, gait speed evaluation and balance assessment.
The patients were asked about duration and severity of morning stiffness, sick leave or job loss due to disease activity and fatigue. They were also asked about history of falls and fractures, fears about falling and use of medication that may increase the risk of falling. Additionally, vitamin D levels and other laboratory tests were evaluated.
Forty (13%) of the patients reported falling in the previous year, with significant demographic and other differences observed between those who fell and those who did not, according to the researchers. Patients who had a history of falling were older, had longer disease duration, were more likely to have missed work due to disease symptoms, and had higher BASMI and BAFSI scores and lower SPPB scores. Patients who reported falling were also more likely to have lost job due to disease symptoms than those who did not report falling, and were more likely to have hip involvement, a history of fractures and were significantly more afraid of falling, according to the researchers.
The most frequent type of fracture was forearm in 13 patients, but only related to falls in three patients. Five patients had foot and ankle fractures, with one related to a fall. One patient had a tibia fracture related to falling.
The researchers observed no significant correlations between the number of falls and gender, morning stiffness, polypharmacy, knee involvement, use of antidepressants or myorelaxants, number of AS-related sick days, BASDAI, erythrocyte sedimentation rate, C-reactive protein levels, or 25(OH) vitamin D levels. However, swollen and tender joints were modifiable risks for falls. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.