Objective:
To describe the rates of falls, injurious falls, and activity restriction due to fear of falling in a population of patients with hemophilia.
Methods:
As part of a study on identifying fall risk in patients with hemophilia, subjects completed a self-administered questionnaire inquiring about fall history over the previous 12 months.
Summary:
75 patients with hemophilia between the ages of 18 and 85 completed the questionnaire. 59 (79%) of these patients had hemophilia A, and 16 (21%) had hemophilia B. 34 (45%) had severe disease, 17 (23%) had moderate disease, and 24 (32%) had mild disease.
25 (33%) of the subjects reported a fall within the last 12 months. The average and median ages of the subjects who fell were 46 and 45 respectively, while the average and median ages of the non-fallers were 41 and 39.5 respectively. Of the 25 patients who fell, 11 (44% of fallers or 15% of total sample) reported an injury caused by the fall. 12 patients (16%) reported restricting activity due to fear of falling. The majority of subjects who reported a fall or injurious fall had mild disease (55 %.), with an average age of 45 and median age of 46.5. The majority of subjects who restricted activity due to fear of falling had mild disease (50%), with most subjects who restricted activity reporting a fall in the previous 12 months (58%)
Conclusions:
Fall rates in hemophilia patients in this study (33%) are similar to or higher than the fall rates found in community dwelling adults 65 years and older (22-33%), although the subjects in this study were younger. Injurious fall rates found in the study (15%) are higher than non-fatal injurious fall rates described in adults age 65 and up (5-11.5%), and similar to those found in adults with arthritis age 45 and up (16.2%). Subjects in this study with mild disease were more likely to fall and to be injured. Activity restriction due to fear of falling (16%) was lower than that found in older adults in other populations (20-60%).
This study suggests that fall risk screening may be an important component of the comprehensive evaluation of patients with hemophilia, including those with mild disease. These results should be confirmed in a larger population of patients and across different treatment centres. Further research into optimal fall risk screening, in-depth assessment and treatment in this population is warranted.