Prevalence of Falls in a Pooled US Cohort of Adults with Systemic Lupus Erythematosus: a Nested Cross-Sectional Study

Objective Epidemiologic data on falls in the population with systemic lupus erythematosus (SLE) remain sparse. We estimated the prevalence and correlates of falls among adults with SLE and compared SLE prevalence estimates with those in the general US population. Methods We assessed falls in a nested cross-sectional study within two pooled population-based SLE cohorts in California (3/2025–2/2026) and Georgia (10/2019–5/2022). Stratified prevalence was assessed with marginal estimates from logistic regression models with falls as the outcome. Age-standardised and sex-standardised estimates in SLE were compared with 2023 US population estimates (ages ≥45 only). Results In this pooled SLE cohort (N=780; mean age, 47.9; 91.9% women; 14.5% Asian, 51.7% black, 13.2% Hispanic), 26.0% reported any fall in the prior year; among these, 59.1% reported falling two times or more and 31.0% reported associated injuries. General factors (oldest vs youngest age (37.4% vs 20.7% for ≥65 vs 20–44)) and SLE-related factors (higher SLE activity (38.5% vs 13.5%), moderate-to-severe depressive symptoms (40.0% vs 23.7%), greater pain interference (43.8% vs 16.5%), greater fatigue (39.2% vs 18.8%) and lower cognitive function (39.7% vs 18.9%)) were statistically significantly associated with higher fall prevalence in the SLE cohort. Among those aged ≥45, the age-standardised and sex-standardised prevalence estimate in the SLE population (22.9%) was similar to the US population estimate (19.5%). Conclusion The prevalence of falls in SLE is high and recurrence is common, suggesting clinical assessment of falls—especially in those with high disease activity and symptoms—is important in SLE.