Rheumatoid arthritis (RA) is an autoimmune disorder caused by autoantibodies that target multiple organs, resulting in slowly progressive destruction of the joints [1]. The etiology of RA is complex and can occur at any age, especially in middle-aged people, with a high disability rate, and there is currently no complete cure [2,3]. According to epidemiological surveys, the global incidence of RA is 0.5%−1% [4]. The major complaints are muscle weakness and stiff or painful joints of the lower extremities resulting in impaired physical activity, and alterations in gait and balance, which may lead to a particular risk of falls in people with RA [5], [6], [7].
Falls are a major health and social care challenge worldwide [8]. The WHO defines a fall as “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level” [9]. It is estimated that 646,000 fatal falls occur every year, which makes falls the second leading cause of accidental injury death [10]. Falls can also cause a deterioration in gait, balance, and the capacity to execute activities of daily living [11], exerting a significant economic burden on healthcare systems [12]. In addition, it can also lead to complications, such as hip fractures [13], and a decrease in quality of life because of the fear of falling again [14].
Previous studies have demonstrated that RA is associated with a high risk of falls and the incidence of falls in populations with RA ranges from 16% [15] to 50% [16] in prospective studies. And to date, several studies have proposed that the increased risk of falls in patients with RA is associated with factors such as the history of falls [17], swollen or tender joints of the lower extremities [18], deformities [19], or gait changes [20]. However, due to the marked heterogeneity of the RA population, different designs of the studies, and the variability of the fall assessment methods used, there are important discrepancies among studies found in the literature about this theme, which has made it difficult to understand the epidemiology of falls in adults with RA. And because studies have shown that falls can be avoided and reduced [21,22]. Therefore, a detailed understanding of the prevalence and risk factors for falls in adults with RA is important for the prevention and control of falls.
In 2015, Angela Brenton-Rule et al. [23] published a systematic review on the incidence and risk factors for falls in adults with RA. However, due to the limited number available for inclusion at that time, the authors only described the included articles and did not integrate the relevant data. In recent years, however, studies have emerged as researchers continue to focus on falls in patients with rheumatoid arthritis. Therefore, the purpose of current systematic review and meta-analysis is to synthesize the prevalence of falls in adults with RA and to explore the underlying risk factors for falls in adults living with RA.
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