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CDC: Arthritis boosts risk of falls, injuries ‘significantly’

Monday May 12, 2014
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People with arthritis are about 2.5 times more likely to suffer falls that cause injuries when compared with adults without arthritis, according to new data from the CDC.

More than one in three older adults fall each year, and falls are the leading cause of injury-related morbidity and mortality among that population, past studies have shown. The report calls for more fall prevention interventions, especially those including “exercise or physical therapy.”

The findings, which appear in the CDC’s May 2 Morbidity and Mortality Weekly Report, also show adults with arthritis are 2.4 times more likely to suffer two or more falls in a year than those without arthritis.

For the study, researchers used data from 338,734 interviews completed for the 2012 Behavioral Risk Factor Surveillance System, a randomized telephone survey of residents of the 50 states, Washington, D.C., Puerto Rico and Guam. Respondents were age 45 or older and were asked whether they were diagnosed with a form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia and whether they had suffered any falls during the past year. Those who reported one or more falls also were asked whether the fall caused injuries, described as whether they changed their normal activities for at least a day or visited a physician.

The findings showed in all 50 states and Washington, D.C., the prevalence of any fall, multiple falls and fall injuries was “significantly higher” in adults with arthritis compared with adults without arthritis. The unadjusted median state prevalence of arthritis among adults ages 45 and older was 40.1%, the authors wrote.

When the results were adjusted for age, the median prevalence of one fall for adults with arthritis was 15.5% compared with 12.1% in adults without arthritis. Similarly, adults with arthritis had a higher median prevalence than those without arthritis for two or more falls (21.3% vs. 9%) and fall injuries (16.2% vs. 6.5%).

Age-adjusted results showed adults with arthritis had a prevalence of any fall in the past year that was 30% or higher in 46 states and Washington, D.C., in 2012. For 16 states, the age-adjusted prevalence of any fall was 40% or greater for adults with arthritis. The findings also showed no state or U.S. territory had an age-adjusted prevalence of falls that was 30% or greater.

The report’s authors note the number of adults with arthritis is expected to grow as the population ages to an estimated 67 million people by 2030, which will put more adults at higher risk for falls and related injuries.

“Efforts to address this growing public health problem require raising awareness about the link between arthritis and falls, evaluating evidence-based arthritis interventions for their effects on falls, and implementing fall prevention programs more widely through changes in clinical and community practice,” the authors wrote.

Combining arthritis exercise programs proven to reduce pain and muscle weakness with proven fall prevention programs that address muscle weakness, gait and balance problems and other risk factors might further reduce the risk for falls in adults with arthritis, researchers suggested.

“Effective fall prevention interventions can be multifaceted, but the most effective single strategy involves exercise or physical therapy to improve gait, balance, and lower body strength, which have been shown to reduce fall risk by 14%–37%,” the authors wrote. “For an exercise program to be effective in reducing falls it must 1) focus on improving balance, 2) become progressively more challenging, and 3) involve at least 50 hours of practice.”

They note the report has several limitations. Because the data was self-reported, falls might have been underestimated or injuries from falls might have been overestimated. The survey also doesn’t establish whether the falls occurred before or after the arthritis diagnosis, the authors wrote. Survey questions also did not address the severity, location or type of arthritis.

MMWR: www.cdc.gov/mmwr/preview/mmwrhtml/mm6317a3.htm?s_cid=mm6317a3_w


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