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Approved research

Are individuals with inflammatory arthritis at higher risk of falling, and do they have poorer bone health, as assessed by heel ultrasound and dual energy x-ray absorptiometry scanning?

Principal Investigator: Professor Elaine Dennison
Approved Research ID: 11983
Approval date: August 3rd 2015

Lay summary

Individuals who have inflammation of their joints are thought to be at greater risk of breaking bones for several reasons; they may have thinner bones either because of their arthritis, or medication that has been prescribed to help control it, and/ or they may be more likely to fall over if the arthritis involves the joints in their lower legs. This study will look at how commonly falls are reported, and consider the measurements of heel ultrasound that have been made, in people who did or did not report a history of arthritis. These results will inform us regarding the risks faced by arthritis patients to their bone health. The findings will inform strategies to educate patients and their physicians, and will lead to prevention of fracture associated comorbidity. Because fall reduction and medication to improve bone density are currently managed through different patient pathways, it will be important to consider the excess attributable risk of both falls and low bone density in such a large, well characterised population. Although only heel ultrasound measurements are available currently, analyses would include DXA based analysis when these results are available in a subset of Biobank. We request data on self-report of arthritis, including medication use; blood results (ESR; CRP; RF) that may help in further defining groups of patients with some types of arthritis (gout, some types of rheumatoid arthritis),falls history and heel ultrasound measurements (and DXA measurements when available). We will consider risk of falls, and poorer bone health in those with or without arthritis, before and after adjusting for other factors that might be important (for example age, sex, other medical problems, cigarette and alcohol use, physical activity, medication use). Details of statistical analyses can be provided if helpful. We would like to make a phased application with cross-sectional and longitudinal analyses. We request access to the full cohort; in addition we would like to request access to the subset in whom DXA measurements have been performed when available, in addition to linkage to HES.