Background/Purpose: Falls are the leading cause of injury-related morbidity and mortality among older adults (age ≥65 years), with more than one in three falling each year, resulting in direct medical costs of nearly $30 billion. Arthritis can lead to poor neuromuscular function (i.e., gait speed and balance), a major risk factor for falling. Although the association between arthritis and increased falls risk among older adults is well documented, little is known about arthritis and falls among middle-aged adults (45-64 years).  

Methods: We analyzed data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS), an annual, random-digit–dialed landline and cellphone survey representative of the noninstitutionalized adult population aged ≥18 years from the 50 states, DC, Puerto Rico, and Guam (n=338,734 respondents age ≥45 years). Respondents were considered to have arthritis if they answered “yes” to, “Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?” They were considered to have fallen if they answered one or more to, “In the past 12 months, how many times have you fallen?” Those reporting one or more falls were also asked, “How many of these falls caused an injury? By an injury, we mean the fall caused you to limit your regular activities for at least a day or to go see a doctor?” We analyzed number of falls as a categorical (zero, one, or two or more) and binary variable (no falls, or one or more falls). Fall injury was categorized as a binary variable (yes or no). Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated in log binomial and multinomial regression models which adjusted for age, sex, race, education, body mass index (BMI), self-rated health status, physical activity, heart disease, and stroke.

Results: Among middle-aged adults, the prevalence of arthritis, falls, and fall injuries was 33.8%, 25.6%, and 9.7%, respectively, whereas the prevalence among older adults was 53.4%, 27.1%, and 9.6%, respectively. Among middle-aged adults with arthritis, the prevalence of one or more falls, two or more falls, and fall injuries was 1.58 (95% CI: 1.53, 1.63), 1.92 (95% CI: 1.82, 2.02), and 2.10 (95% CI: 1.97, 2.23) times higher compared with middle-aged adults without arthritis. Among older adults with arthritis, the prevalence one or more falls, two or more falls, and fall injuries was 1.38 (95% CI: 1.34, 1.45),  1.69 (95% CI: 1.59, 1.80), and  1.63 (95% CI: 1.52, 1.75) times higher compared with older adults with arthritis.

Conclusion: These findings establish the significant relationship between arthritis and falls and fall injuries among middle-aged adults and demonstrate that these associations are similar in magnitude to those already recognized among older adults.  Raising awareness of falls and fall injuries among middle aged adults is an important first step in mitigating negative fall consequences in this population. The high burden of falls and fall injuries among middle-aged and older adults with arthritis can be addressed through greater dissemination of arthritis management and fall prevention programs in clinical and community practice.

---

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-association-between-doctor-diagnosed-arthritis-and-falls-and-fall-injuries-among-middle-aged-and-older-adults/