Mild Joint Symptoms Are Associated with Lower Risk of Falls than Asymptomatic Individuals with Radiological Evidence of Osteoarthritis

Sumaiyah Mat; Pey June Tan; Chin Teck Ng; Farhana Fadzli; Faizatul I Rozalli; Ee Ming Khoo; Keith D Hill; Maw Pin Tan

doi:10.1371/journal.pone.0141368

Mild Joint Symptoms Are Associated with Lower Risk of Falls than Asymptomatic Individuals with Radiological Evidence of Osteoarthritis

PLoS One. 2015 Oct 22;10(10):e0141368. doi: 10.1371/journal.pone.0141368. eCollection 2015.

Authors

Sumaiyah Mat¹, Pey June Tan¹, Chin Teck Ng², Farhana Fadzli³, Faizatul I Rozalli³, Ee Ming Khoo⁴, Keith D Hill⁵, Maw Pin Tan⁶

Affiliations

¹ Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
² Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapare.
³ Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁴ Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁵ School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
⁶ Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Abstract

Osteoarthritis (OA) exacerbates skeletal muscle functioning, leading to postural instability and increased falls risk. However, the link between impaired physical function, OA and falls have not been elucidated. We investigated the role of impaired physical function as a potential mediator in the association between OA and falls. This study included 389 participants [229 fallers (≥2 falls or one injurious fall in the past 12 months), 160 non-fallers (no history of falls)], age (≥65 years) from a randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Physical function was assessed using Timed Up and Go (TUG) and Functional Reach (FR) tests. Knee and hip OA were diagnosed using three methods: Clinical, Radiological and Self-report. OA symptom severity was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The total WOMAC score was categorized to asymptomatic, mild, moderate and severe symptoms. Individuals with radiological OA and 'mild' overall symptoms on the WOMAC score had reduced risk of falls compared to asymptomatic OA [OR: 0.402(0.172-0.940), p = 0.042]. Individuals with clinical OA and 'severe' overall symptoms had increased risk of falls compared to those with 'mild' OA [OR: 4.487(1.883-10.693), p = 0.005]. In individuals with radiological OA, mild symptoms appear protective of falls while those with clinical OA and severe symptoms have increased falls risk compared to those with mild symptoms. Both relationships between OA and falls were not mediated by physical limitations. Larger prospective studies are needed for further evaluation.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / prevention & control*
Activities of Daily Living*
Aged
Case-Control Studies
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Knee Joint / physiopathology*
Malaysia
Male
Osteoarthritis, Knee / diagnostic imaging*
Osteoarthritis, Knee / pathology
Prognosis
Radiography
Risk Factors
Severity of Illness Index*

Grants and funding

This work was supported by the University of Malaya Research Grant (grant number UMRG-RP-010-2012C) and the Ministry of Science, Technology and Innovation Science Fund (grant number 06-01-03-SF0834), and a Ministry for Higher Education High Impact Research grant (grant number UM.C/625/1/HIR-MOHE/ASH/02). The funders of this study played no part in the design, data collection, data analysis or reporting of the study. They supplied funding for the salaries of SM and PJT, and for the purchase of equipment, consumables and transportation required for the conduct of the study.