What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Rheumatoid arthritis (n=375). Intervention: Physical function, disease activity, and depressive symptoms. Primary outcome: Frailty (assessed by Kihon Checklist).

October 17, 2020

Depression, physical function, and disease activity associated with frailty in patients with rheumatoid arthritis

Key Result

Physical function, disease activity, and depressive symptoms were independently associated with frailty, which affected 18.5% of working-age and up to 36.6% of older patients with rheumatoid arthritis.

Study Design

Type

Cross-Sectional (n=375)

Multicenter

Yes

Structured PICO

What clinical and psychosocial factors are associated with frailty in patients with rheumatoid arthritis?

Population

375 patients aged 40 to 79 years with rheumatoid arthritis evaluated for associations between clinical/psychosocial factors and frailty.

Outcome

Factors associated with frailty (evaluated by Kihon Checklist)patient reported

Frailty is common in RA patients across age groups and is independently associated with physical function, disease activity, and depressive symptoms.

Abstract

OBJECTIVES: To investigate the clinical and psychosocial backgrounds of frailty in rheumatoid arthritis (RA) patients. METHODS: Patients with RA between 40 and 79 years of age who visited university hospitals in an urban area were recruited. Well-validated self-reported questionnaires were used to evaluate patient physical function (Health Assessment Questionnaire, HAQ), depressive symptoms (Beck Depression Inventory-II, BDI-II), and frailty (Kihon Checklist). A 28-point Disease Activity Score (DAS-28) was calculated to evaluate RA disease activity. RESULTS: A total of 375 RA patients, 323 of whom were women, were enrolled (average age: 65.2 ± 9.7 years; average disease duration: 16.6 ± 11.9 years). The prevalence rates of frailty, working-age (40-64 years), young-old (65-74 years), and old-old (≥75 years) patients were 18.5, 28.8, and 36.6%, respectively. Higher age and longer disease duration were associated with frailty. Multivariable logistic regression analysis revealed that HAQ, DAS-28, and BDI-II scores were independently associated with frailty in RA patients. CONCLUSION: Frailty is common, even among working-age RA patients. Physical function, disease activity, and depressive symptoms were independently associated with frailty. A multidisciplinary intervention approach, along with adequate pharmacological therapy, may promote successful aging in patients with RA.

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